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					                                          Addendum to the Federal Stafford Loan Master Promissory Note
                                                    Federal Family Education Loan Program
The Higher Education Reconciliation Act of 2005, the College Cost Reduction and Access           a fixed interest rate. However, different fixed interest rates may apply to separate
Act of 2007, the Ensuring Continued Access to Student Loans Act of 2008, the Higher              loans made under the MPN depending on whether the loan is subsidized or
Education Opportunity Act of 2008, and regulations issued by the U.S. Department of              unsubsidized, when the loan is first disbursed, and whether you are an undergraduate
Education (the Department) on November 1, 2007 and October 23, 2008 changed some                 or graduate student. In addition, the following sentences are added: “If I qualify under
of the terms of Federal Stafford Loans made under the Federal Family Education Loan              the Servicemembers Civil Relief Act, the interest rate on my loans obtained
Program (FFELP). As a result, certain terms of the loan(s) you receive under the                 prior to military service may be limited to 6% during my military service. To receive this
accompanying Federal Stafford Loan Master Promissory Note (MPN) differ from                      benefit, I must contact my loan holder for information about the documentation I must
the terms in the MPN and Borrower’s Rights and Responsibilities Statement.                       provide to show that I qualify.”
This Addendum describes the changes made to the loan terms by the laws and                     • Borrower’s Rights and Responsibilities Statement: Item 14, Payment of Interest.
regulations listed above. Your loan is subject to these changes. The changes set                 The first sentence in this item is revised to read as follows: “My lender will, during the
forth in this Addendum are incorporated into and made a part of the accompanying                 in-school, grace, and deferment periods and during any period in which I am on active-
MPN that you sign and the Borrower’s Rights and Responsibilities Statement.                      duty military service, postpone and align principal payments on my outstanding FFELP
                                                                                                 loans, except for Federal PLUS Loans and Federal Consolidation Loans.”
• MPN: Borrower Certifications and Authorizations. By signing your MPN, you
   are certifying, under penalty of perjury, that if you have been convicted of, or have       • Borrower’s Rights and Responsibilities Statement: Item 15, Loan Cancellation.
   pled nolo contendere or guilty to, a crime involving fraud in obtaining federal student       The first bullet in the second paragraph is revised to read as follows: “If my school
   assistance under Title IV of the Higher Education Act of 1965, as amended, you have           receives the money by EFT or master check and has obtained my written confirmation
   completed the repayment of such funds to the Department, or to the loan holder in the         of the types and amounts of federal student loans that I want to receive before
   case of a Title IV federal student loan.                                                      crediting the loan funds to my account, I may cancel all or a part of that loan by
                                                                                                 informing the school within 14 days after the date the school notifies me of my right
• MPN: Borrower Certifications and Authorizations, Item 14E. The first part of this              to cancel the loan, or by the first day of the school’s payment period, whichever is
   item is revised to read as follows: “I request and authorize my lender to: (i) during the     later. (My school can tell me the first day of the payment period.) If my school has not
   in-school and grace periods of any loans made under this Master Promissory Note,              obtained my written confirmation of the loans I want to receive, I may cancel all or a
   defer and align the repayment of principal on all of my FFELP loans, except for               part of the loan by informing the school within 30 days of the date the school notifies
   Federal PLUS Loans and Federal Consolidation Loans, that are in repayment                     me of my right to cancel the loan. If I cancel all or a portion of a loan as described in
   status; and (ii)…”                                                                            this paragraph, my school will return the cancelled amount to my lender, and the loan
                                                                                                 fees will be eliminated or reduced in proportion to the amount returned.”
• MPN: Governing Law and Notices. This item is revised to include the following
   statement: “Information about my loan(s) will be submitted to the National Student          • Borrower’s Rights and Responsibilities Statement: Item 16, Sale or Transfer of
   Loan Data System (NSLDS). Information in NSLDS is accessible to schools, lenders,             Loans. The second sentence is revised to read as follows: “If ownership of a loan is
   and guarantors for specific purposes as authorized by the Department.”                        transferred and the entity to which I must make payments changes, I will be notified
• Borrower’s Rights and Responsibilities Statement: Item 4, Maximum Program                      of that entity’s name, address and telephone number, the effective date of the sale
   Loan Amounts. Effective for loans first disbursed on or after July 1, 2008, the annual        or transfer, and the date when I must begin sending payments to that entity.”
   and aggregate loan limits are as follows:                                                   • Borrower’s Rights and Responsibilities Statement: Item 17, Loan Discharge.
                                                                                                 A loan is eligible for discharge if it is determined that the borrower’s eligibility for the
                                               Subsidized         Subsidized and                 loan was falsely certified as a result of a crime of identity theft. In addition, the second,
                                                                   Unsubsidized                  third, and fourth sentences of the first paragraph are replaced by the following text:
    Dependent Undergraduates 1                   Annual            Total Annual                  “My loan(s) may also be discharged if I become totally and permanently disabled as
        First Year                               $3,500               $5,500                     defined by the Act and meet certain other requirements.”
        Second Year                              $4,500               $6,500
        Third Year and Beyond                    $5,500               $7,500                   • Borrower’s Rights and Responsibilities Statement: Item 20, Special Repayment
    Independent Undergraduates 2
                                                                                                 Arrangements. A married couple may no longer borrow a Federal Consolidation
                                                                                                 Loan as joint borrowers. A borrower may consolidate his or her FFELP loans into the
        First Year                               $3,500                $9,500
                                                                                                 William D. Ford Federal Direct Loan (Direct Loan) Program to take advantage of the
        Second Year                              $4,500               $10,500
                                                                                                 public service loan forgiveness program. This program provides for the cancellation of
        Third Year and Beyond                    $5,500               $12,500
                                                                                                 the remaining balance due on eligible Direct Loan Program loans after the borrower
    Graduate and Professional Students           $8,500               $20,500                    has made 120 payments (after October 1, 2007) on those Direct Loans under certain
                                                Aggregate         Total Aggregate                repayment plans while the borrower is employed in certain public service jobs.
    Dependent Undergraduates 1                     $23,000              $31,000
    Independent Undergraduates 2                   $23,000              $57,500                  A borrower may also consolidate his or her FFELP loans first disbursed on or after
    Graduate and Professional Students             $65,500             $138,500                  October 1, 2008 (including Federal Consolidation Loans that repaid FFELP or Direct
      1 except students whose parents are unable to borrow under the PLUS program
                                                                                                 Loan Program loans first disbursed on or after October 1, 2008) into the Direct Loan
      2 and dependents whose parents are unable to borrow under the PLUS program
                                                                                                 Program to take advantage of the no accrual of interest benefit for active duty service
                                                                                                 members. No interest will be charged on the portion of a Direct Consolidation Loan
• Borrower’s Rights and Responsibilities Statement: Item 7, Loan Fees. This item                 that repaid FFELP or Direct Loan Program loans first disbursed on or after October 1,
   is revised to read as follows: “I may be charged an origination fee and/or a federal          2008 during periods of qualifying active duty military service (for up to 60 months).
   default fee for each loan made under this MPN. Neither fee may exceed the rate as             The Act may provide for certain loan forgiveness or repayment benefits on a
   specified in the Act. If I am charged these fees, they will be deducted proportionately       borrower’s FFELP loans in addition to the benefits described in this MPN. If other
   from each disbursement.” NOTE: Any reference to a guarantee fee in the MPN is                 forgiveness or repayment options become available, a borrower’s loan holder will
   deemed to be a reference to the federal default fee.                                          provide information about these benefits.
• Borrower’s Rights and Responsibilities Statement: Item 8, Disbursement of Loan               • Borrower’s Rights and Responsibilities Statement: Item 21, Deferments. A
   Money. Loan money for students enrolled in foreign schools generally must be sent to          deferment is available for a period during which a borrower is serving on active duty
   the school and disbursed in multiple installments.                                            during a war or other military operation or national emergency, or performing qualifying
• Borrower’s Rights and Responsibilities Statement: Item 12, Repayment. Effective                National Guard duty during a war or other military operation or national emergency,
   July 1, 2009, an Income-Based Repayment Plan is available to eligible borrowers.              and if a borrower is serving on or after October 1, 2007, for an additional 180-day
   Under this plan, the required monthly payment amount will be based on a borrower’s            period following the demobilization date for the qualifying service. A borrower who is a
   income during any period when the borrower has a partial financial hardship. The              member of the National Guard or other reserve component of the U. S. Armed Forces
   maximum repayment period under this plan may exceed 10 years. Eligible borrowers              (current or retired) and who is called or ordered to active duty while enrolled at least
   who meet certain requirements over a 25-year period may qualify for cancellation of           half time at an eligible school, or within 6 months after having been enrolled at least
   any outstanding balance on their loans.                                                       half time, is eligible for a deferment during the 13 months following the conclusion of
                                                                                                 the active duty service, or until the date the borrower returns to enrolled student status
• Borrower’s Rights and Responsibilities Statement: Item 13, Interest Rates.                     on at least a half-time basis, whichever is earlier.
   Effective for loans first disbursed on or after July 1, 2006, a Federal Stafford Loan has
                                                                                                                                                     To be used with OMB No. 1845-0006
                                                                                                                                                                     Exp. Date 2-29-2008
                                                                                  Federal Stafford Loan Plain Language Disclosure

This Disclosure summarizes information concerning your loan. Please refer to your Federal Stafford           than 8.25%. Some variable interest rate loans have an interest rate that is lower during in-school,
Loan Master Promissory Note (MPN), Borrower’s Rights and Responsibilities Statement, and loan-               grace, and deferment periods, and higher during repayment and forbearance periods. Interest is
specific disclosure for the complete terms and conditions of your loan. Except as specifically stated in     charged on the unpaid principal amount. Interest charges begin on the date the loan is disbursed
this Disclosure, those documents govern the terms and conditions of your loan.                               and end when the loan is paid in full. For subsidized loans, the federal government pays your interest
                                                                                                             charges while you attend school at least half time, for 6 months after the day you leave school or drop
Please read this Disclosure carefully, print the document if it has been delivered in an electronic form,    below half-time enrollment status at your school, and while you have a deferment on your loan. You
and maintain a hard copy in a safe place. If you have questions about your loan, contact your lender.        must pay all other interest charges on your subsidized loan. For unsubsidized loans, you must pay all
1. General - You are receiving a Federal Stafford Loan to help cover the costs of your education. You        interest charges. You agree that the lender may add interest charges to your loan amount, as provided
must repay this loan. You are responsible for repaying this loan even if you are dissatisfied with your      by law, if you do not make payments of interest. Since the federal government does not make any
education, do not complete it, or cannot find work in your area of study. Borrow only the amount you         interest payments for you on unsubsidized loans, you will repay more interest on unsubsidized loans
need.                                                                                                        than on subsidized loans. If you qualify under the Servicemembers Civil Relief Act, the interest rate
                                                                                                             on your loans obtained prior to military service may be limited to 6% during your military service. To
By accepting your loan proceeds, you are certifying, under penalty of perjury, that if you have been         receive this benefit, you must contact your loan holder for information about the documentation you
convicted of, or have pled nolo contendere or guilty to, a crime involving fraud in obtaining federal        must provide to show that you qualify.
student assistance under Title IV of the Higher Education Act of 1965, as amended (the Act), you have
completed the repayment of such funds to the U.S. Department of Education (the Department)                   10. Late Charges and Collection Costs - Your lender may collect a late charge from you if you do
or to the loan holder in the case of a Title IV federal student loan.                                        not make any part of a payment within 15 days after it is due. Your lender may only collect one late
                                                                                                             charge for each payment, no matter how many days the payment is late. Your lender may also collect
Information about your loan(s) will be submitted to the National Student Loan Data System (NSLDS).           from you certain limited charges and fees involved in collecting your loan in accordance with the
Information in NSLDS is accessible to schools, lenders, and guarantors for specific purposes as              Department’s regulations.
authorized by the Department.
                                                                                                             11. Loan Consolidation - If you are no longer enrolled in school as at least a half-time student and
2. Loan Cancellation - Before your lender sends your loan money to your school, you may cancel               you are in the grace period or in the repayment period on your loan, you may be eligible to consolidate
or reduce the amount of your loan by writing to your school or lender. After your loan money is sent to      all of your eligible federal education loans into one loan. Consolidating your loans may give you up to
your school, you may cancel all or part of your loan by notifying your school within certain time frames.    30 years to pay them back and may lower your monthly payments; however, you may be repaying
If your school has obtained your written confirmation of the types and amounts of loans you want to          your loans for a longer period and pay more interest. Contact your lender for more information about
receive before crediting the loan funds to your account, you may cancel all or a part of that loan by        consolidating your loans.
informing the school within 14 days after the date the school notifies you of your right to cancel the
loan, or by the first day of the school’s payment period, whichever is later. If your school has not         12. Deferments - You do not have to make payments in certain circumstances. For example, you will
obtained your written confirmation of the loans you want to receive, you may cancel all or part of the       not have to make payments while you are attending school at least half time or for up to 3 years while
loan by informing the school within 30 days of the date the school notifies you of your right to cancel      you are unemployed. A deferment is also available while you are serving on active duty during a war
the loan. If you cancel all or a portion of a loan as described in this paragraph, your school will return   or other military operation or national emergency, or performing qualifying National Guard duty during
the cancelled amount to your lender, and the loan fees will be eliminated or reduced in proportion to        a war or other military operation or national emergency and if you are serving on or after October 1,
the amount returned. You may also pay back all or a part of your loan within 120 days of the date your       2007, for an additional 180-day period following the demobilization date for your qualifying service.
lender sends your loan money to your school, and your loan fees will be eliminated or reduced.               If you are a member of the National Guard or other reserve component of the U.S. Armed Forces
                                                                                                             (current or retired) and you are called or ordered to active duty while you are enrolled at least half time
3. Federal Stafford Loan MPN - If you continue to attend a participating school located in the United        at an eligible school, or within 6 months of having been enrolled at least half time, you are eligible for
States, you may receive multiple loans under the same MPN for up to 10 years. You may write to your          a deferment during the 13 months following the conclusion of your active duty service, or until the date
lender to stop loans from being made under your MPN. You will need to sign a new MPN if you want             you return to enrolled student status on at least a half-time basis, whichever is earlier. This is not a
to change your lender or if you transfer between a Federal Family Education Loan Program (FFELP)             complete list of available deferments. For a complete list of deferments, and all documentation and
school and a William D. Ford Federal Direct Loan (Direct Loan) Program school.                               eligibility requirements, please refer to your Borrower’s Rights and Responsibilities Statement and any
4. Loan Amount - There are annual and total limits on the amounts you may borrow, as explained               supplemental information you may receive. The federal government pays the interest on subsidized
in the Borrower’s Rights and Responsibilities Statement you previously received. The total amount            loans during periods of deferment. You must pay the interest on unsubsidized loans during deferment
you borrow cannot be more than these limits. Your school determines the amount you are eligible to           periods, or it will be added to the principal amount of the loan. If interest is added to the principal
borrow using federal guidelines. Effective for Federal Stafford Loans first disbursed on or after July 1,    amount, you will then pay interest on the larger amount. Having interest added to the principal
2008, the annual and aggregate loan limits are as follows:                                                   amount of your loan may also cause your monthly payment amount to increase.
                                                             Subsidized                Subsidized and        13. Forbearance - If you cannot make scheduled payments and do not qualify for a deferment, your
                                                                                        Unsubsidized         lender may allow you to temporarily make smaller payments or temporarily stop making payments.
  Dependent Undergraduates 1                                   Annual                   Total Annual
                                                                                                             This is called a forbearance. Interest will be charged on your loan during forbearance. The lender
                                                                                                             must grant you a forbearance in certain cases, as described in your Borrower’s Rights and
    First Year                                                 $3,500                      $5,500            Responsibilities Statement.
    Second Year                                                $4,500                      $6,500
    Third Year and Beyond                                      $5,500                      $7,500            14. Loan Discharge - Your loan will be discharged (forgiven) when (i) acceptable documentation of
  Independent Undergraduates 2                                                                               your death is given to your lender, (ii) you cannot complete a course of study because your school
                                                                                                             closes, (iii) your school falsely certifies your loan eligibility, (iv) a loan in your name was falsely certified
    First Year                                                $3,500                       $9,500            as a result of a crime of identity theft, or (v) you become totally and permanently disabled and meet
    Second Year                                              $4,500                       $10,500            certain other requirements. Your loan may also be discharged up to the amount of any refund that
    Third Year and Beyond                                    $5,500                       $12,500            your school should have made, but did not send to your lender. Your loan will not automatically be
  Graduate & Professional Students                           $8,500                       $20,500            discharged in bankruptcy.
                                                           Aggregate                  Total Aggregate         15. Consumer Reporting Agency Notification - Information about your loan will be reported to
   Dependent Undergraduates 1                                $23,000                      $31,000            national consumer reporting agencies. Information will include the disbursement date, amount, and
   Independent Undergraduates 2                              $23,000                      $57,500            repayment status of your loan (for example, whether you are current or behind schedule in making
   Graduate and Professional Students                        $65,500                     $138,500            payments).
1 except students whose parents are unable to borrow under the PLUS program
                                                                                                             16. Default and Acceleration - If you default on your loan, that fact will be reported to all national
2 and dependents whose parents are unable to borrow under the PLUS program
                                                                                                             consumer reporting agencies. All unpaid amounts and collection fees on your loan will become
5. Use of Loan Money - You may only use your loan money to pay educational expenses (e.g.,                   immediately due and payable. You may be sued, your wages may be garnished, you may lose federal
tuition, room, board, books) at the school that certified your loan eligibility. If you accept this loan,    payments, and/or your tax refund may be withheld. You agree to pay reasonable collection fees and
your eligibility for other student assistance may be affected.                                               costs, plus court costs and attorney fees. You may face other serious consequences.
6. Origination Fee and Federal Default Fee - Federal law requires an origination fee and a federal           17. Sale or Transfer of Your Loan - Your lender may sell or assign your loan without your consent
default fee for each loan made under this MPN. (Before July 1, 2006, the federal default fee was called      and without selling or assigning any of your other loans. The sale or transfer of your loan does not
a guarantee fee or insurance premium.) The law specifies the maximum amount of each fee and                  affect your rights and responsibilities with respect to the loan. If ownership of a loan is transferred
authorizes both fees to be deducted from your loan amount.                                                   and the entity to which you must make payments changes, you will be notified of that entity’s name,
                                                                                                             address and telephone number, the effective date of the sale or transfer, and the date when you must
7. Change of Status or Address - You must tell your school and/or lender if you stop attending               begin sending payments to that entity.
school, no longer attend school on at least a half-time basis, or transfer to another school. You must
also tell your lender any time you change your address, telephone number, e-mail address, name               18. Department of Defense Repayment Program - Under certain circumstances, military personnel
(e.g., maiden name to married name) or employer, or if the address or telephone number of your               may have their loan(s) repaid by the Secretary of Defense. You should address any questions you
employer changes.                                                                                            have to the local service recruiter. This is a recruiting program and generally does not pertain to
                                                                                                             prior service individuals or those not eligible for enlistment in the Armed Forces.
8. Repayment - You must repay the full loan amount, and all interest on your loan, generally within
10 years. You will receive a 6-month grace period that starts the day after you leave school or drop         19. Loan Forgiveness for Public Service Employees Program - You may consolidate your FFELP
below half-time enrollment status at your school. You do not have to make payments during your               loans into the Direct Loan Program to take advantage of the public service loan forgiveness program.
grace period. You must make payments after your grace period ends according to the schedule                  This program provides for the cancellation of the remaining balance due on eligible Direct Loan
provided by your lender. Your lender will give you the choice of a Standard Repayment Plan, a                Program loans after you have made 120 payments (after October 1, 2007) on those Direct Loans
Graduated Repayment Plan, an Income-Sensitive Repayment Plan or, if you are eligible, an Extended            under certain repayment plans while you are employed in certain public service jobs.
Repayment Plan. Effective July 1, 2009, if you are eligible, you may also choose an Income-Based             20. No Accrual of Interest for Active Duty Service Members - You may consolidate your FFELP
Repayment Plan under which your monthly payment will be based on your income during any period               loans first disbursed on or after October 1, 2008 (including Federal Consolidation Loans that repaid
when you are experiencing a partial financial hardship. You may request to change your repayment             FFELP or Direct Loan Program loans first disbursed on or after October 1, 2008) into the Direct Loan
plan at any time, but your lender may limit you to one such change each year. These plans are                Program to take advantage of the no accrual of interest benefit for active duty service members. No
designed to give you flexibility in meeting your repayment obligation. You may make loan payments            interest will be charged on the portion of a Direct Consolidation Loan that repaid FFELP or Direct Loan
before they are required, or in amounts greater than required, at any time without penalty. When you         Program loans first disbursed on or after October 1, 2008 during periods of qualifying active duty
pay back your loan in full, the current loan holder may send you a notice telling you that you have          military service (for up to 60 months).
paid off your loan instead of returning the original MPN. You should keep this notice in a safe place.
                                                                                                             21. Other Loan Forgiveness and Repayment Benefits - The Act may provide for certain loan
9. Interest - Loans with a first disbursement on or after July 1, 2006, have a fixed interest rate that is   forgiveness or repayment benefits on your loans in addition to the benefits described in your MPN. If
specified in the Higher Education Act. However, different fixed interest rates may apply to loans made       other forgiveness or repayment options become available, your loan holder will provide information
under the MPN depending on whether the loan is subsidized or unsubsidized, when the loan is first            about these benefits.
disbursed, and whether you are an undergraduate or graduate student. Loans made prior to July 1,
2006 have a variable interest rate that may change each year on July 1 and that will never be more
                                                                                                                                                                                                          Revised 03-27-2009
Federal Family Education Loan Program (FFELP)                                                                                      Guarantor, Program, or Lender Identification                                      OMB No. 1845-0006
                                                                                                                                                                                                                     Form approved

Federal Stafford Loan
                                                                                                                                                                                                                     Exp. date 07/31/2011



Master Promissory Note (MPN)
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any accompanying
document is subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW LOAN ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions
to obtain, verify, and record information that identifies each person who opens a loan account. What this means for you: Your name, address, date of birth, and other information collected in this form will be used to verify
your identity. You may also be asked to provide your driver’s license or other identifying documents.
Borrower Information                                                                                                                            Print using a dark ink ballpoint pen or type. Read the instructions on page 3 carefully.
1. Last Name                                                                       First Name                                                                          MI                 2. Social Security Number



3. Permanent Address (See instructions.)                                                                                           4. Area Code/Telephone Number                          5. Date of Birth (mm-dd-yyyy)

                                                                                                                                      (                )
   City                                                                            State                       Zip Code            6. Driver’s License State and Number                   7. E-mail Address

                                                                                                                                      State        #
8. Lender Name                                                                     City                                               State                               Zip Code        9. Lender Code, if known



10. References: You must provide two separate adult references with different U.S. addresses who have known you for at least three years. The first reference should be a parent (if living) or legal guardian. Both references must be
    completed in full.
    Name                                  A.                                                                                               B.

     Permanent Address

     City, State, Zip Code

     E-mail Address

     Area Code/Telephone Number                        (                )                                                                                      (              )

     Relationship to Borrower
 11. Requested Loan Amount: I request a total amount of subsidized and/or unsubsidized loans under this MPN not to 12. Interest Payments (Optional):
     exceed the annual and aggregate loan limits authorized under the Higher Education Act of 1965, as amended. My
     school will notify me of the type(s) and amount(s) of loan(s) that I am eligible to borrow. I may cancel my loan   q If I receive any unsubsidized Federal Stafford Loan(s) under this MPN, I want to pay the interest on the
     or request a lower amount by contacting my lender or school. Additional information about my right to cancel a          loan(s) while I am in school.
     loan or request a lower amount is included in the Borrower’s Rights and Responsibilities Statement and disclosure
     statements that have been or will be provided to me.

Borrower Certifications and Authorizations                                                                                                                                                         Read carefully before signing below.

 13. Under penalty of perjury, I certify for any loan I receive under this MPN that:                                                      C. I authorize my school to transfer loan proceeds received by electronic funds transfer (EFT)
     A. The information I have provided on this MPN and as updated by me from time to time is                                                or master check to my student account at the school.
        true, complete, and correct to the best of my knowledge and belief and is made in good faith.                                     D. I authorize my school to pay to the lender any refund that may be due up to the full loan
     B. Loan proceeds will be used for authorized educational costs that I incur. I will immediately                                         amount.
        repay any loan proceeds that cannot be attributed to educational costs for attendance on at                                       E. I request and authorize my lender to: (i) during the in-school and grace periods of any
        least a half-time basis at the school that certified my loan eligibility.                                                            loans made under this MPN, defer and align the repayment of principal on all of my Federal
     C. If I owe an overpayment on a Federal Perkins Loan, Federal Pell Grant, Federal Supplemental                                          Stafford Loans held by the lender that are in repayment status; and (ii) add the unpaid
        Educational Opportunity Grant, Academic Competitiveness Grant (ACG), National Science                                                interest that accrues on any Federal Stafford Loan to the principal balance of the loan
        and Mathematics Access to Retain Talent (SMART) Grant, or Leveraging Educational                                                     (capitalization) during forbearance periods and, for unsubsidized loans, during in-school,
        Assistance Partnership Grant, I have made satisfactory arrangements with the holder to                                               grace, and deferment periods as provided under the Act. Capitalization will increase the
        repay the amount owed.                                                                                                               principal balance on my loan(s) and the total amount of interest I must pay.
     D. If I am in default on any loan received under the Federal Perkins Loan Program (including                                         F. I authorize the school, the lender, the guarantor, the Department, and their respective
        NDSL loans), the Federal Direct Loan Program, or the Federal Family Education Loan                                                   agents and contractors to contact me regarding my loan request(s) or my loan(s), including
        Program (“FFELP” as defined in the Borrower’s Rights and Responsibilities Statement), I                                              repayment of my loan(s), at the current or any future number that I provide for my cellular
        have made satisfactory arrangements with the holder to repay the amount owed.                                                        telephone or other wireless device using automated telephone dialing equipment or artificial
     E. If I have been convicted of, or pled nolo contendere (no contest) or guilty to, a crime involving                                    or prerecorded voice or text messages.
        fraud in obtaining funds under Title IV of the Higher Education Act of 1965, as amended, I have                                   G. I authorize the release of information pertinent to my loan(s): (i) by the school(s), the
        completed the repayment of such funds to the U.S. Department of Education (the Department),                                          lender, and the guarantor(s), or their agents to the references on the applicable loan(s) and
        or to the loan holder in the case of a Title IV federal student loan.                                                                to members of my immediate family unless I submit written directions otherwise; and (ii)
 14. For all subsidized and unsubsidized Federal Stafford Loans (as described in the additional MPN                                          by and among my school(s), lender(s), guarantor(s), the Department, and their agents.
     provisions and the Borrower’s Rights and Responsibilities Statement) I receive under this MPN,                                       H. To verify information I provide and so that the loan(s) requested can be approved,
     I make the following authorizations:                                                                                                    I authorize the Department to send any information about me that is under its control,
     A. I authorize my school to certify my eligibility for loans under this MPN.                                                            including information from the Free Application for Federal Student Aid, to the school,
     B. I authorize the lender, the guarantor, or their agents to investigate my credit record and                                           to the lender, and to state agencies and nonprofit organizations that administer financial
        report information concerning my loan status to persons and organizations permitted by law                                           aid programs under the FFELP. I understand that information reported on this MPN may
        to receive such information.                                                                                                         be shared with the Department, and that the Department has the authority to verify that
                                                                                                                                             information with other federal agencies.

Promise to Pay                                             In this MPN,“lender” refers to, and this MPN benefits, the original lender and its successors and assigns, including any subsequent holder of this MPN.

 15. I promise to pay to the order of the lender all loan amounts disbursed (hereafter “loan” or “loans”) under the terms of this MPN, plus interest and other charges and fees that may
     become due as provided in this MPN. I understand that, if I qualify, more than one loan may be made to me under this MPN. I understand that by accepting any disbursements
     issued at any time under this MPN, I agree to repay the loan(s). I understand that, within certain time frames, I may cancel or reduce the amount of any loan by refusing to accept or
     by returning all or a portion of any disbursement that is issued. Unless I make interest payments, interest that accrues on my unsubsidized loan(s) during in-school, grace, deferment,
     forbearance, and other periods may be added as provided under the Act to the principal balance of such loan(s). If I do not make any payment on any loan made under this MPN when it
     is due, I will also pay reasonable collection costs including, but not limited to, attorney fees, court costs, and other fees. I will not sign this MPN before reading the entire MPN, even if I
     am told not to read it, or told that I am not required to read it. I am entitled to a copy of this MPN and the Borrower’s Rights and Responsibilities Statement. My signature certifies I have
     read, understand, and agree to the terms and conditions of this MPN, including the Borrower Certifications and Authorizations printed above, the Notice about Subsequent Loans Made
     under This MPN, and the Borrower’s Rights and Responsibilities Statement.
      I UNDERSTAND THAT I MAY RECEIVE ONE OR MORE LOANS UNDER THIS MPN AND THAT I MUST REPAY ALL LOANS THAT I RECEIVE UNDER THIS MPN.
 16. Borrower Signature                                                                                                                                    17. Today’s Date (mm-dd-yyyy)
                                                                                                                                                                                                       Additional MPN provisions follow
Federal Stafford Loan Master Promissory Note (MPN) (continued)
Governing Law                                                      be deducted from my loan amount. The fee(s) I am charged,             lender or guarantor reasonably concludes I no longer intend
                                                                   as identified in the disclosure statement, will be deducted           to honor my repayment obligation. If I default, the guarantor
The terms of this MPN will be interpreted in accordance            proportionately from each disbursement of my loan(s). I               may purchase my loan(s) and capitalize all outstanding
with the Higher Education Act of 1965, as amended (20              understand the origination and federal default fees may be            interest into a new principal balance. The new principal
U.S.C. 1070 et seq.), the U.S. Department of Education’s           refundable only to the extent permitted by the Act.                   balance and collection fees will become immediately due
(the Department’s) regulations, as they may be amended in                                                                                and payable.
accordance with their effective date, and other applicable         Late Charges and Collection Costs
federal statutes and regulations (collectively referred to as                                                                            If I default, the default will be reported to all national
the “Act”), and the guarantor’s policies. Applicable state law,    The lender may collect from me: (i) a late charge for                 consumer reporting agencies and will significantly and
except as preempted by federal law, may provide for certain        each late installment payment if I do not make any part               adversely affect my credit history. I understand that a
borrower rights, remedies, and defenses in addition to those       of a required installment payment within 15 days after the            default will have additional adverse consequences to me
stated in this MPN.                                                date it becomes due, and (ii) any other charges and fees              as disclosed in the Borrower’s Rights and Responsibilities
                                                                   that are specifically permitted by the Act for the collection of      Statement. Following default, the loan(s) may be subject to
Disclosure of Terms                                                my loan(s). If I default on any loan(s), I will pay reasonable        income-based or income-contingent repayment (including
                                                                   collection fees and costs, plus court costs and attorney fees.        potential collection of amounts in excess of the principal and
This MPN applies to both subsidized and unsubsidized
                                                                                                                                         interest) in accordance with the Act.
Federal Stafford Loans. Loans disbursed under this MPN             Repayment
are subject to the loan limits specified in the Act. Under this                                                                          Legal Notices
MPN, the principal amount that I owe, and am required to           I must repay the full amount of the loan(s) made under
repay, will be the sum of all disbursements issued (unless I       this MPN and accrued interest. Federal Stafford Loans have a          Any lender holding a loan made under this MPN is subject
reduce or cancel any disbursements as provided below).             repayment grace period, which will be disclosed in                    to all claims and defenses that I could assert against the
                                                                   my disclosure statement. I will repay the principal of each           school with respect to that loan if (i) the loan was made by
My lender will determine whether to make any loan under            loan in periodic installments during a repayment period               the school or a school-affiliated organization, (ii) the lender
this MPN after my eligibility is determined by the school.         that begins on the day immediately following the end of               who made the loan provided an improper inducement (as
At or before the time of the first disbursement for each           the 6-month grace period.                                             defined by the Act) to the school or to any other party in
loan, a disclosure statement will be provided to me                                                                                      connection with the making of the loan, (iii) the school refers
identifying the amount of the loan and additional terms of         I understand that the school’s certification of my loan
                                                                                                                                         loan applicants to the lender, or (iv) the school is affiliated
the loan. Important additional information is also disclosed       eligibility determines whether my loans are subsidized and/or
                                                                                                                                         with the lender by common control, contract, or business
in the Borrower’s Rights and Responsibilities Statement            unsubsidized loans.
                                                                                                                                         arrangement. My recovery under this provision will not
accompanying this MPN. The Borrower’s Rights and                                                                                         exceed the amount I paid on the loan.
                                                                   I will have a choice of repayment plans as provided in the
Responsibilities Statement and any disclosure statement
                                                                   Act. My repayment period for each loan generally lasts at
I receive in connection with any loan under this MPN are                                                                                 Information about my loan(s) will be submitted to the
                                                                   least 5 years but may not exceed 10 years (except under an
hereby incorporated into this MPN. If the information in this                                                                            National Student Loan Data System (NSLDS). Information in
                                                                   extended or income-based repayment plan). The maximum
MPN conflicts with information in the disclosure, the specific                                                                           NSLDS is accessible to schools, lenders, and guarantors for
                                                                   period for repaying a loan does not include periods of
terms and information in the disclosure apply to my loan.                                                                                specific purposes as authorized by the Department.
                                                                   deferment or forbearance.
I may request additional loan funds for my educational costs,                                                                            If I reside in the state in which the principal office of the
                                                                   The lender will provide me with a repayment schedule that
up to the annual and aggregate loan limits as specified in the                                                                           guarantor is located, the guarantor may sue to enforce the
                                                                   identifies my payment amounts and due dates. Except as
Act. The school will determine my eligibility and notify my                                                                              applicable loan(s) in the county in which the guarantor’s
                                                                   otherwise provided in the Act, the minimum annual payment
lender. I will be notified of any increase or other change in                                                                            office is located. However, if I object to being sued there and
                                                                   required on all my FFELP loans is $600 or the amount of
the amount of my loan(s).                                                                                                                I mail a written objection to the guarantor that is postmarked
                                                                   interest due and payable, whichever is larger. Payments
                                                                                                                                         no later than 30 days after I am served with the suit, the
I agree that the lender may sell or assign this MPN and/or         submitted by me or on my behalf (exclusive of refunds)
                                                                                                                                         guarantor will either have the court transfer the suit to the
my loan(s) and acknowledge that any loan may be assigned           may be applied first to charges and collection costs that are
                                                                                                                                         county in which I live or will dismiss the lawsuit.
independently of any other loan to which this MPN applies.         due, then to accrued interest that has not been capitalized,
I agree that each loan is separately enforceable based on          and finally to the principal amount, except during periods of         Any notice required to be given to me will be effective if
a true and exact copy of this MPN. I understand that my            repayment under an income-based repayment plan, when                  sent by first class mail to the latest address the lender has
lender may use a servicer to handle billing and other              payments will be applied first to interest due, then to fees          for me or by electronic means to an address that I have
communications related to my loan.                                 due, and then to the principal amount.                                provided. I will immediately notify the lender of any change
                                                                                                                                         of address or status as specified in the Borrower’s Rights
Loan Cancellation                                                  If I am unable to make my scheduled loan payments, the
                                                                                                                                         and Responsibilities Statement. Failure by the lender
                                                                   lender may allow me to reduce my payment amount, to
                                                                                                                                         to enforce or insist on compliance with any term of this
I may pay back all or a part of a disbursement within time         extend the time for making payments, or to temporarily
                                                                                                                                         MPN will not be a waiver of any right of the lender. No
frames set by the Act and explained in the Borrower’s              stop making payments as long as I intend to repay my
                                                                                                                                         provision of this MPN may be modified or waived except
Rights and Responsibilities Statement or other disclosure          loan(s). Allowing me to temporarily delay or reduce loan
                                                                                                                                         in writing. If any provision of this MPN is determined to
I receive at or before disbursement. In such case, any             payments is called forbearance. The lender may align
                                                                                                                                         be unenforceable, the remaining provisions remain
origination fee and federal default fee will be reduced or         payment due dates on my loans or grant me a forbearance
                                                                                                                                         in force.
eliminated in proportion to the amount of the disbursement         to eliminate a delinquency that persists even though I am
returned. I will not incur interest charges if I return the full   making scheduled payments.
loan amount as provided in the Act.
                                                                   I may prepay all or any part of the unpaid balance on my                 Notice about Subsequent Loans
Interest                                                           loan(s) at any time without penalty. If I do not specify which           Made under This MPN
                                                                   loan(s) I am prepaying, the lender will determine how to
Unless my lender notifies me in writing of a lower rate(s),        apply the prepayment in accordance with the Act. Upon
the rate(s) of interest for my loan(s) is that specified in        payment in full of each loan under this MPN, I agree to                  This MPN authorizes the lender to disburse multiple
the Act. Interest rate information is presented in the             accept written notification of such loan payoff in place of              loans to pay my educational costs during the multi-
Borrower’s Rights and Responsibilities Statement                   receiving the original MPN.                                              year term of this MPN. Such loans will be made only
accompanying this MPN. The interest rate for each loan is                                                                                   upon my request and upon the school’s certification
presented in a disclosure that is issued to me.                    Acceleration and Default                                                 of my loan eligibility. Subsequent loans may be made
Interest accrues on the unpaid principal balance of each           At the option of the lender, the entire unpaid balance of                for the same or subsequent periods of enrollment
loan from the date of disbursement by the lender until the         a loan made under this MPN will become immediately                       at schools designated by the Secretary of the U.S.
entire principal balance is paid in full. I agree to pay all       due and payable if any one of the following events occurs                Department of Education.
interest charges on my subsidized Federal Stafford Loan(s)         regarding that loan: (i) I do not enroll as at least a half-time
except interest payable by the federal government under the        student at the school that certified my loan eligibility, (ii) I do      I understand that no subsequent loan(s) will be made
Act. I agree to pay all interest charges on my unsubsidized        not use the proceeds of the loan solely for my educational               under this MPN after the earliest of the following
Federal Stafford Loan(s). If I do not make required payments       costs, (iii) I make a false representation that results in my            dates: (i) the date my lender receives my written
of interest before the beginning or resumption of principal        receiving a loan for which I am not eligible, or (iv) I default          notice that no further loans may be disbursed under
repayment, or during a period of authorized deferment or           on the loan.                                                             the MPN; (ii) one year after the date of my signature
forbearance, I agree that the lender may capitalize such
                                                                   The following events will constitute a default on a loan:                on this MPN if no disbursement is made during such
interest to the extent permitted by the Act.
                                                                   (i) I do not pay the entire unpaid balance of the applicable             twelve-month period; or (iii) ten years after either
Origination Fee and Federal Default Fee                            loan after the lender has exercised its option under items               the date of my signature on this MPN, or the date the
                                                                   (i), (ii), or (iii) in the preceding paragraph; (ii) I do not make       lender receives this MPN.
An origination fee and a federal default fee may be charged        installment payments when due, provided my failure has
for each loan made under this MPN. The Act specifies the           persisted for at least 270 days for payments due monthly                 Any change to the Act applies to loans in accordance
maximum amount of each fee and authorizes both fees to             or 330 days for payments due less frequently than monthly;               with the effective date of the change.
                                                                   or (iii) I do not comply with other terms of the loan, and the
Federal Family Education Loan Program (FFELP)                                                         Guarantor, Program, or Lender Identification


Federal Stafford Loan
Master Promissory Note (MPN)
Instructions and Notices
This is an MPN under which you may receive multiple subsidized and unsubsidized Federal Stafford Loans over a maximum 10-year period. Except for interest the federal government
pays on your behalf on subsidized Federal Stafford Loans while you are in school, during your grace and deferment periods, and for a limited period during income-based repayment,
you are responsible for paying the principal amount of your loan(s) and all interest that accrues from the date of disbursement until the loan(s) is paid in full.

Print using a dark ink ballpoint pen or type. Do not complete      Item 5: Enter the date of your birth. Be careful not to enter         outside the U.S. are not acceptable. If a reference does not
this form in pencil. If an item has been completed for you         the current year.                                                     have a telephone number or e-mail address, or does not wish
and it is incorrect, cross out the incorrect information and                                                                             to provide an e-mail address, enter N/A. If you provide an
print the correct information. Enter dates as month-day-year       Item 6: Enter the two-letter abbreviation for the state that          e-mail address for a reference, the lender or holder of your
(mm-dd-yyyy). Use only numbers. Example: June 24, 1982             issued your driver’s license followed by the driver’s license         loan(s) may use it to communicate with the reference. All
= 06-24-1982. Incorrect, incomplete, or illegible information      number. If you do not have a driver’s license, enter N/A.             items must be completed or your loan will be delayed.
may cause your loan to be delayed.                                 Item 7: Enter your preferred e-mail address for receiving             Item 11: Each time you request Federal Stafford Loan funds,
Item 1: Enter or correct your last name, first name, and           communications. You are not required to provide this                  the school will notify you of the amount of funds you are
middle initial.                                                    information. If you do, the lender or holder of your loan(s)          eligible to borrow. You may decline a loan or request a lower
                                                                   may use your e-mail address to communicate with you. If               amount by contacting your lender or the school. You should
Item 2: Enter or correct your Social Security Number.              you do not have an e-mail address or do not wish to                   apply only for what you will need to pay your educational
Your loan(s) cannot be processed without a Social Security         provide it, enter N/A.                                                costs each year. Additional information is included under
Number. Read the Privacy Act and Financial Privacy                                                                                       “Loan Cancellation” in the Borrower’s Rights and Responsi-
Act Notices in these instructions before completing this item. Item 8: Enter the name and address of the lender from                     bilities Statement.
                                                               which you wish to borrow. If you do not have a lender,
Item 3: Enter your permanent address (number, street,          contact the school’s financial aid office, a bank or other                Item 12: Check this box only if you want to make interest
apartment number) or rural route number and box number,        financial institution, or the guarantor or program listed                 payments while in school.
then city, state, and zip code. If your mailing address is a   on this form for information on lenders willing to make
post office box or general delivery, you must list both your   Federal Stafford Loans.                                                   Items 13 and 14: Read these items carefully.
mailing address and your street address or your rural route
number and box number. If you do not have a permanent          Item 9: Enter the lender code, if known. Otherwise, leave this            Item 15: Read the entire MPN carefully. Then complete Items
street address or rural route number and box number, provide item blank.                                                                 16 and 17.
the physical location of your residence. A temporary school    Item 10: Enter reference information for two adults with                  Item 16: Sign your legal name, including your first name,
address is not acceptable.                                     different addresses who have known you for at least three                 middle initial, and last name.
Item 4: Enter the area code and telephone number at            years. The first reference should be a parent (if living), legal
                                                               guardian, or an adult relative. References with addresses                 Item 17: Enter the date you are signing this MPN.
which you can most easily be reached. If you do not have a
telephone, enter N/A.

Important Notices

Privacy Act Notice                                                  verify compliance with federal student financial aid program         Financial Privacy Act Notice
                                                                    regulations, or to locate you if you become delinquent in
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the           your loan payments or if you default. To provide default rate        Under the Right to Financial Privacy Act of 1978
following notice be provided to you:                                calculations, disclosures may be made to guaranty agencies,          (12 U.S.C. 3401-3421), the U.S. Department of Education
                                                                    to financial and educational institutions, or to state agencies.     will have access to financial records in your student loan
The authority for collecting the requested information                                                                                   file maintained by the lender in compliance with the
from and about you is §421 et seq. of the Higher Education          To provide financial aid history information, disclosures
                                                                    may be made to educational institutions. To assist program           administration of the Federal Family Education
Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and                                                                               Loan Program.
the authorities for collecting and using your Social Security       administrators with tracking refunds and cancellations,
Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)           disclosures may be made to guaranty agencies, to financial           Paperwork Reduction Notice
(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family     and educational institutions, or to federal or state agencies.
Education Loan Program (FFELP) and giving us your SSN are           To provide a standardized method for educational institutions        According to the Paperwork Reduction Act of 1995, no
voluntary, but you must provide the requested information,          to efficiently submit student enrollment status, disclosures         persons are required to respond to a collection of information
including your SSN, to participate.                                 may be made to guaranty agencies or to financial and                 unless it displays a currently valid OMB control number. The
                                                                    educational institutions. To counsel you in repayment                valid OMB control number for this information collection is
The principal purposes for collecting the information on            efforts, disclosures may be made to guaranty agencies,               1845-0006. The time required to complete this information is
this form, including your SSN, are to verify your identity,         to financial and educational institutions, or to federal,            estimated to average 0.75 hours (45 minutes) per response,
to determine your eligibility to receive a loan or a benefit        state, or local agencies.                                            including the time to review instructions, search existing data
on a loan (such as a deferment, forbearance, discharge, or                                                                               resources, gather and maintain the data needed, and complete
forgiveness) under the FFELP, to permit the servicing of your       In the event of litigation, we may send records to the               and review the information collection. If you have any
loan(s), and, if it becomes necessary, to locate you and to         Department of Justice, a court, adjudicative body, counsel,          comments concerning the accuracy of the time estimate(s)
collect and report on your loan(s) if your loan(s) becomes          party, or witness if the disclosure is relevant and necessary        or suggestions for improving this form, please write to:
delinquent or in default. We also use your SSN as an                to the litigation. If this information, either alone or with other
account identifier and to permit you to access your                 information, indicates a potential violation of law, we may          U.S. Department of Education
account information electronically.                                 send it to the appropriate authority for action. We may send         Washington, DC 20202-4537
                                                                    information to members of Congress if you ask them to help           If you have any comments or concerns regarding the
The information in your file may be disclosed, on a case-           you with federal student aid questions. In circumstances
by-case basis or under a computer matching program,                                                                                      status of your individual submission of this form, contact
                                                                    involving employment complaints, grievances, or disciplinary         the lender, guarantor, or program identified in the upper
to third parties as authorized under routine uses in the            actions, we may disclose relevant records to adjudicate
appropriate systems of records notices. The routine uses of                                                                              right-hand corner of this form.
                                                                    or investigate the issues. If provided for by a collective
this information include, but are not limited to, its disclosure    bargaining agreement, we may disclose records to a labor
to federal, state, or local agencies, to private parties such as    organization recognized under 5 U.S.C. Chapter 71.
relatives, present and former employers, business and               Disclosures may be made to our contractors for the purpose
personal associates, to consumer reporting agencies, to             of performing any programmatic function that requires
financial and educational institutions, and to guaranty             disclosure of records. Before making any such disclosure,
agencies in order to verify your identity, to determine your        we will require the contractor to maintain Privacy Act
eligibility to receive a loan or a benefit on a loan, to permit     safeguards. Disclosures may also be made to qualified
the servicing or collection of your loan(s), to enforce the         researchers under Privacy Act safeguards.
terms of the loan(s), to investigate possible fraud and to
Borrower’s Rights and Responsibilities Statement
Important Notice: The Borrower’s Rights and Responsibilities Statement provides additional information about the terms and conditions of loans you receive under the Federal
Stafford Loan Master Promissory Note (MPN). Please keep a copy of this statement because it applies to present and subsequent loans received under the MPN. You may contact
your lender at any time for another copy of this statement.
The following types of loans are currently available under       full academic year;                                  5. Use of Loan Money – I must use the loan money for
the Federal Family Education Loan Program (FFELP):           n My cost of attendance;                                 authorized educational costs incurred for attendance at
n Subsidized Federal Stafford Loan,                          n My expected family contribution;                       the school that certified my eligibility for the time period
n Unsubsidized Federal Stafford Loan,                        n Other financial aid I receive;                         shown on my disclosure statement. Authorized costs
n Federal PLUS Loan,                                         n My remaining eligibility under the annual and          include the following:
n Federal Consolidation Loan.                                    aggregate loan limits; and                           n Tuition,
                                                             n Other provisions authorized by the Act.                n Room,
The FFELP is authorized by Title IV, Part B of the
                                                                                                                      n Board,
Higher Education Act of 1965, as amended.                    If I am an undergraduate student, my school must         n School fees,
                                                             determine my eligibility for a Federal Pell Grant before
I must complete a Free Application for Federal Student                                                                n Books,
Aid (FAFSA) before I receive a subsidized or unsubsidized I receive a Federal Stafford Loan. My school must           n Supplies,
                                                             determine my eligibility for a subsidized Federal
Federal Stafford Loan.                                                                                                n Equipment,
                                                             Stafford Loan before determining my eligibility for an   n Dependent child care,
1. Governing Law – Loans disbursed under this MPN are unsubsidized Federal Stafford Loan. If I do not qualify
                                                                                                                      n Transportation,
subject to the Higher Education Act of 1965, as amended for a subsidized Federal Stafford Loan, I may receive up
                                                                                                                      n Commuting costs,
(20 U.S.C. 1070 et seq.) and applicable U.S. Department to the maximum annual loan limit in an unsubsidized
                                                                                                                      n Rental or purchase of a personal computer,
of Education regulations (collectively referred to as the    Federal Stafford Loan.                                   n Origination fee and federal default fee, and/or
“Act”). NOTE: Any change to the Act applies to loans in
                                                             If I have received federal student loans from more than  n Other documented, authorized costs.
accordance with the effective date of the change.
                                                             one lender or from other federal student loan programs,  6. Loan Fees – I may be charged an origination fee and/or
2. Use of This MPN – I may receive more than one loan        I am responsible for informing my school and my          a federal default fee for each loan made under this MPN.
under this MPN over a period not to exceed 10 years.         lender(s) of my other student loans. In some cases, I    Neither fee may exceed the rate specified in the Act.
I may receive loans under this MPN from the original         may not be eligible for loans for which I have applied.  If I am charged these fees, they will be deducted
lender or from a lender who assumes the right to offer
                                                                                                                      proportionately from each disbursement.
loans under this MPN, even if I change schools and even
                                                                          Federal Stafford Loan Annual Limits
if the guarantor changes. I may request in writing that                                                               7. Disbursement of Loan Money – My loan money will
no further loans be disbursed under my MPN. If I wish           Dependent Undergraduates                              be disbursed to the school by electronic funds transfer
to use a new lender, I must sign a new MPN. I must also         (except students whose parents are unable             (EFT), master check (one check covering multiple
sign a new MPN before receiving a new loan if requested         to borrow a PLUS loan)                                students), or individual check. If my loan money is
to do so by my lender.                                          First Year Total                             $5,500   disbursed by individual check, the check will be sent to
                                                                (maximum $3,500 subsidized)                           the school and may be copayable to me and the school
3. Subsidized and Unsubsidized Loans – There
are two types of Federal Stafford Loans that I may              Second Year Total                            $6,500   or payable to me.
be eligible for under this MPN: subsidized and                  (maximum $4,500 subsidized)
                                                                                                                      Generally, my loan money will be disbursed in multiple
unsubsidized. The subsidized Federal Stafford Loan              Third Year and Beyond Total (each year)      $7,500   installments based on the academic terms at my school.
is based on need. If I qualify, the government pays             (maximum $5,500 subsidized)                           If my school does not have academic terms or does not
the lender the interest due on my subsidized loans              Independent Undergraduates                            have academic terms that meet certain requirements,
while I am in school at least half time and during grace        (and dependent undergraduates whose parents           my loan money will generally be disbursed in at least
and deferment periods (“lender” refers to the original          are unable to borrow a PLUS loan)                     two installments, one at the beginning and one at the
lender and its successors, including any subsequent                                                                   midpoint of my enrollment period for the applicable loan.
                                                                First Year Total                             $9,500
holder of this MPN). I am otherwise responsible for             (maximum $3,500 subsidized)
interest that accrues on my subsidized loan. The                                                                      If my loan money exceeds the amount owed to the
                                                                Second Year Total                            $10,500  school, my school will forward the remainder of my loan
unsubsidized Federal Stafford Loan is not based on need.
                                                                (maximum $4,500 subsidized)                           money to me, unless I authorize the school to hold the
I am responsible for all interest that accrues on my
unsubsidized loans.                                             Third Year and Beyond Total (each year)      $12,500  remainder as a credit balance.
                                                                (maximum $5,500 subsidized)
4. Loan Limits – The charts on this page show the                                                                     If I am enrolled in a study-abroad program through
                                                                Graduate and Professional Students
maximum Stafford Loan amounts (subsidized and                                                                         a school in the U.S. (home school), the loan money
unsubsidized) that I may borrow under the FFELP and             Total Amount (each year)                     $20,500  will be disbursed to my home school or, if I request,
the William D. Ford Federal Direct Loan (Direct Loan)           (maximum $8,500 subsidized)                           directly to me. I may provide the home school a written
Program combined for a single academic year (annual                                                                   authorization designating an individual not affiliated with
loan limits) and the maximum amounts I may borrow in                     Federal Stafford Loan Aggregate Limits       the home school as my power-of-attorney to negotiate
total for undergraduate and graduate study (aggregate           Dependent Undergraduates                              any loan disbursements on my behalf.
loan limits). The annual and aggregate loan limits for          (except students whose parents are unable
independent undergraduates also apply to dependent              to borrow a PLUS loan)
                                                                                                                      If I am enrolled in a foreign school, my loan money
undergraduates whose parents are unable to borrow               Total Amount Cumulative                      $31,000  will be disbursed to the foreign school or, if the foreign
under the PLUS program. If I am enrolled in certain             (maximum $23,000 subsidized)
                                                                                                                      school requests, directly to me.
health professions programs, I may qualify for higher
                                                                Independent Undergraduates
annual and aggregate loan limits on unsubsidized Federal        (and dependent undergraduates whose parents           If this is my first Stafford Loan under either the FFELP
Stafford Loans.                                                 are unable to borrow a PLUS loan)                     or the Federal Direct Loan Program, I must receive
The actual loan amount I receive for an academic year           Total Amount Cumulative                               entrance counseling before my school delivers the first
                                                                                                             $57,500
may be less than the annual loan limits shown in the            (maximum $23,000 subsidized)                          disbursement of my subsidized or unsubsidized Federal
Federal Stafford Loan Annual Limits chart and will be                                                                 Stafford Loan.
                                                                Graduate and Professional Students
determined by my school, based on my academic level
                                                                Total Amount Cumulative                      $138,500
(freshman, sophomore, etc.), dependency status, and
                                                                (maximum $65,500 subsidized;
other factors, such as:                                         includes Stafford Loans received
n The length of the program or the remaining portion of         for undergraduate study)
    the program in which I am enrolled, if it is less than a
8. Change of Status – I must notify my school and/or           in accordance with the “Loan Cancellation” section of            If I do not pay the interest that is due on my Federal
lender or any subsequent holder of my loan(s) of certain       this Borrower’s Rights and Responsibilities Statement.           Stafford Loan(s) as described in the “Subsidized and
changes.                                                       If I qualify under the Servicemembers Civil Relief Act,          Unsubsidized Loans” section of this Borrower’s Rights
                                                               the interest rate on my loans obtained prior to military         and Responsibilities Statement, my lender may capitalize
I must notify my school’s financial aid office if any of the   service may be limited to 6% during my military service.         that interest as provided under the Act.
following occurs:                                              To receive this benefit, I must contact my loan holder for
n I reduce my enrollment status to less than half time,        information about the documentation I must provide to            The principal balance of my loan(s) will increase each
n I withdraw from school,                                      show that I qualify.                                             time my lender capitalizes unpaid interest. As a result, I
n I stop attending classes,                                                                                                     will pay more interest over the life of my loan(s) than if I
n I do not re-enroll for any term,                             12. Payment of Interest – I am responsible for payment           paid the interest as it accrued, and my monthly payment
n I have a change in my expected graduation date, and/         of all interest that accrues on the unpaid principal             amount may be higher or more monthly payments may
   or                                                          amount of my Federal Stafford Loan(s) from the date              be required.
n I change my name, local address, permanent                   of disbursement until the loan(s) is paid in full, except
                                                                                                                                I should contact my lender if I have any questions or
   address, or e-mail address.                                 for interest on my subsidized Federal Stafford Loan(s)
                                                                                                                                need more information.
                                                               the government pays on my behalf while I am in school
Shortly before my enrollment ends, I must participate          at least half time, for up to 3 years during active-             The chart below compares the monthly payments that
in exit counseling with my school, during which I will         duty service in the Armed Forces as described in the             result for subsidized or unsubsidized Federal Stafford
update my loan records about my:                               “Grace Period” section of this Borrower’s Rights and             Loans in forbearance status when the borrower pays
n Permanent address,                                           Responsibilities Statement, during the grace period              accrued interest and when the interest is capitalized.
n E-mail address,                                              after I leave school, during any period of authorized            This example uses a fixed interest rate of 6.8% and
n Telephone number,                                            deferment, or (effective July 1, 2009) for a limited period      an outstanding loan balance of $15,000. The interest
n Future employer, and                                         during income-based repayment if I choose that plan and          capitalized in this example is based on capitalization
n References.                                                  am eligible for that plan.                                       at the end of a 12-month forbearance period and
I must notify the lender of a particular loan if I do not      My lender will, during the in-school, grace, and                 is an estimate only. Actual interest capitalized for a
enroll with respect to such loan:                              deferment periods and during any periods in which I am           period of forbearance will depend on the frequency of
n At least half time for the loan period certified, or         on active-duty military service, defer and align principal       capitalization. The final payment may be more or less
n At the school that certified my eligibility.                 payments on my subsidized and unsubsidized Federal               than the calculated monthly payment. In this example,
                                                                                                                                I would pay $11 less per month and $389 less over
I must notify my lender or any subsequent holder of            Stafford Loans.
                                                                                                                                the lifetime of my loans when I pay the interest as it is
my loan(s) if any of the following occurs before my            Interest that accrues on all my subsidized FFELP loans           charged during a 12-month forbearance period.
loan(s) is repaid:                                             during authorized forbearance periods, and on all my
n I change my address, telephone number, or e-mail             unsubsidized FFELP loans during periods when I am                                         When I pay When I don’t
   address,                                                    not making regularly scheduled payments (for example,                                     accrued    pay accrued
n I change my name (for example, maiden name to                during deferment) may, unless precluded by the Act, be                                    interest   interest and it
   married name),                                              capitalized (added to the principal of my loans) — unless                                            is capitalized
n I withdraw from school or begin attending less than          I pay the interest as it accrues. If I inform my lender that I
   half time,                                                  wish to pay interest as it accrues (for example, during an        Loan principal          $15,000        $15,000
n I transfer to another school,                                in-school deferment), but I do not submit the payments,           Interest for 12         $1,020         $1,020
n I change my employer or my employer’s address or             my lender may capitalize that interest. Capitalized interest      months (at an           (paid as       (unpaid and
   telephone number changes, and/or                            increases the principal balance of my loan(s) and the             interest rate           accrued)       capitalized)
n I have any other change in status that would affect my       total amount of interest I must pay.                              of 6.8%)
   loan (for example, the loss of eligibility for an
   unemployment deferment by obtaining a job).                 Interest will be capitalized on my loan(s) as provided            Principal to            $15,000        $16,020
                                                               under the Act. Generally, capitalization may occur no             be repaid
9. Effect of Federal Loans on Other Student Aid –              more frequently than quarterly. However, interest that
Receipt of a Federal Stafford Loan may affect my               accrues on my unsubsidized Federal Stafford Loan(s)               Monthly                 $173           $184
eligibility for other financial aid. Therefore, it may be      during in-school, grace, or deferment periods may only            payment amount
beneficial to contact my school to discuss other types         be capitalized at the end of such periods. In addition,           (standard
of student assistance that may be available.                   interest may not be capitalized if my lender grants an            repayment plan)
10. Grace Period – I will receive a 6-month grace              administrative forbearance for up to 60 days in order             Number of               120            120
period before the first payment of my Federal Stafford         to collect and process documentation supporting                   payments
Loan must be made. The grace period begins the day             my request for a deferment, forbearance, change in
after I cease to be enrolled at least half time at an          repayment plan, or consolidation. See the “Interest               Total amount repaid      $21,734       $22,123
eligible school.                                               Capitalization” section of this Borrower’s Rights and
                                                               Responsibilities Statement for further information on            14. Loan Cancellation – I understand that the terms
My grace period does not include any period of up to 3         capitalization.                                                  of a full or partial loan cancellation depend on when
years during which I am called or ordered to active duty                                                                        I request the cancellation.
for more than 30 days from a reserve component of the          The charts entitled “Repaying Your Loans” at the end of
                                                                                                                                n At any time before my loan money is disbursed, I may
Armed Forces of the United States, including the period        the Borrower’s Rights and Responsibilities Statement
                                                                                                                                   decline all or part of my loan money by notifying my
necessary for me to resume enrollment at the next              allow me to estimate the cost of capitalization and the
                                                                                                                                   lender or the school. No origination fee, federal default
available regular enrollment period.                           effect it will have on my monthly payments. If my loan
                                                                                                                                   fee, or interest will be charged on the loan amount that
                                                               amount is not shown on the charts, I understand I must
11. Interest Rates – The interest rate on a Federal                                                                                I decline.
                                                               add two or more amounts together to estimate more
Stafford Loan (subsidized or unsubsidized) will be a                                                                            n If my school receives the money by EFT or master
                                                               closely my monthly interest and my monthly payment.
fixed rate. Different fixed interest rates may apply                                                                               check and has obtained my written confirmation of
to separate loans made under this MPN depending                I may be able to claim a federal income tax deduction for           the types and amounts of federal student loans that
on whether the loan is subsidized or unsubsidized,             interest payments I make on my FFELP loans. For further             I want to receive before crediting the loan funds to
when the loan is first disbursed, and whether I am an          information, I may refer to IRS Publication 970, available          my account, I may cancel all or a part of that loan by
undergraduate or graduate student. The actual interest         at http://www.irs.gov.                                              informing the school within 14 days after the date
rate applicable to each of my loans will be disclosed                                                                              the school notifies me of my right to cancel the loan,
                                                               13. Interest Capitalization – Capitalization is a process
to me. After reviewing the actual interest rate, I may                                                                             or by the first day of the school’s payment period,
                                                               whereby a lender adds unpaid interest to the principal
cancel or reduce any loan obtained under this MPN                                                                                  whichever is later. (My school can tell me the first day
                                                               balance of a loan.                                                  of the payment period.) If my school has not obtained
  my written confirmation of the loans I want to receive,        payment amount will be based on my income during             In certain cases, the Act provides for loan discharge
  I may cancel all or a part of the loan by informing the        any period when I have a partial financial hardship.         if I could not complete a course of study because the
  school within 30 days of the date the school notifies          My monthly payment amount may be adjusted                    school closed, if my loan eligibility was falsely certified
  me of my right to cancel the loan. If I cancel all or a        annually. The maximum repayment period under this            by the school, or if a loan in my name was falsely
  portion of a loan as described in this paragraph, my           plan may exceed 10 years. If I choose this plan and          certified as a result of a crime of identity theft. The Act
  school will return the cancelled amount to my lender,          meet certain requirements over a 25-year period, I           also provides for loan discharge in the amount of any
  and the loan fees will be eliminated or reduced in             may qualify for cancellation of any outstanding balance      required refund that the school did not make to my loan
  proportion to the amount returned.                             on my loans. I may contact my lender at any time for         holder on my behalf.
n At any time within 120 days of disbursement, I may             more information about this repayment plan.
                                                                                                                              Neither the lender, the guarantor, nor the Department of
  pay back all or a part of my loan. The loan fees will
                                                               Under each plan, the number or amount of the payments          Education vouches for the quality or suitability of the
  be reduced or eliminated in proportion to the
                                                               may need to be adjusted to reflect capitalized interest        academic programs offered by participating schools.
  amount returned.
                                                               and/or new loans made to me.                                   Unless I qualify for loan discharge under the Act, I
15. Repayment – All loans made under this MPN must                                                                            must repay the loan(s) even if I do not complete the
                                                               These repayment plans will be explained in more detail
be repaid.                                                                                                                    education paid for with the loan(s), am unable to obtain
                                                               during my exit counseling session. If I do not choose an       employment in the field of study for which the school
The repayment period for each loan made under this             income-sensitive, income-based, graduated, or extended         provided training, or am dissatisfied with, or do not
MPN begins the day after my 6-month grace period on            repayment plan within 45 days after notification of my         receive, the education paid for with the loan(s).
that loan ends. My lender will notify me of the date my        repayment choices, or if I choose an income-sensitive
first payment is due.                                          repayment plan but do not provide the required                 For additional information, I should contact my lender
                                                               documentation within the lender-specified time frame,          or guarantor.
I am obligated to make payments on my loan(s) even if          my lender will require that I repay the loan(s) under
I do not receive a billing statement or repayment notice.                                                                     18. Consequences of Default – Default is defined in
                                                               a standard repayment plan. If I choose an income-
My minimum annual payment required on all my FFELP                                                                            detail in my MPN. If I default, the entire unpaid balance
                                                               based repayment plan but do not provide the required
loans will not, unless the lender otherwise agrees, be                                                                        and collection fees on the applicable loan(s) will become
                                                               documentation within the time frame specified by the
less than $600, except during a portion of the repayment                                                                      immediately due and payable. Failure to repay any loan
                                                               lender, I will be required to repay the loan(s) under a
period as provided in a graduated or income-sensitive                                                                         made under this MPN may result in any or all of the
                                                               schedule provided by the lender in accordance with
repayment plan, in an extended repayment plan with                                                                            following:
                                                               the Act. I may change the repayment plan on my
graduated payments, or in an income-based repayment                                                                           n Loss of federal and state income tax refunds,
                                                               loan(s) once a year, except I may end an income-based
plan. Notwithstanding the preceding sentence, my                                                                              n Loss of other federal or state payments,
                                                               repayment plan at any time to repay under the standard
minimum annual scheduled payments will not be less                                                                            n Legal action against me,
                                                               repayment plan.
than the amount of interest due and payable, except as                                                                        n Collection charges (including attorney fees)
provided under an income-based repayment plan.                 There will be no penalty for prepaying any portion of             assessed against me,
                                                               my loan(s).                                                    n Denial or loss of a professional license,
My repayment period for each loan generally lasts at                                                                          n An increase in my interest rate,
least 5 years but may not exceed 10 years from the day         Except as provided by the Act for payments made under          n Loss of eligibility for other student aid and
after the grace period ends (except under an extended or       the income-based repayment plan, all payments and                 assistance under most federal benefit programs,
income-based repayment plan). The maximum period               prepayments may be applied in the following order:             n Loss of eligibility for loan deferments,
for repaying a loan does not include periods of                late charges, fees, and collection costs authorized by         n Negative credit reports to consumer
deferment or forbearance.                                      the Act first, outstanding accrued interest second, and           reporting agencies,
                                                               outstanding principal last.                                    n Assignment of my loan to the Department, and/or
I will be given the opportunity to choose one of the
following repayment plans:                                     If I do not make any part of an installment payment            n My employer withholding part of my wages to
n Standard Repayment Plan – If I choose this plan,             within 15 days after if becomes due, I may owe a late             give to my guarantor or the Department
   I will make fixed monthly payments and repay my             charge. This charge may not exceed six cents for each             (administrative wage garnishment).
   loan(s) in full within 10 years from the date the loan(s)   dollar of each late installment.
                                                                                                                              19. Consumer Reporting Agency Notification –
   entered repayment. Payments must be at least $50
                                                               16. Sale or Transfer of Loan(s) – The lender may sell          Information concerning the amount, disbursement, and
   a month and will be more if necessary to repay the
                                                               or otherwise transfer one or all of my loans without my        repayment status (current or delinquent) of my loan(s)
   loan(s) within the required time period.
                                                               consent. If ownership of a loan is transferred and the         will be reported by my lender to national consumer
n Graduated Repayment Plan – If I choose this plan,
                                                               entity to which I must make payments changes, I will           reporting agencies on a regular basis. My loan(s) will
   I will usually make lower monthly payments at first,
                                                               be notified of that entity’s name, address and telephone
   and my payments will increase over time. No single                                                                         be identified as an education loan(s). If I default on
                                                               number, the effective date of the sale or transfer, and the
   payment will be more than three times greater than                                                                         any loan(s) made under this MPN, the default will also
                                                               date when I must begin sending payments to that entity.
   any other payment. I will repay my loan(s) in full                                                                         be reported by the guarantor to all national consumer
                                                               Sale or transfer of my loan(s) does not affect my rights
   within 10 years from the date the loan(s) entered                                                                          reporting agencies. Before any guarantor reports such a
                                                               and responsibilities under such loan(s). If the lender sells
   repayment.                                                                                                                 default, it will give me at least 30 days notice that default
                                                               my loan(s) to another originating lender, the lender may
n Extended Repayment Plan – If I choose this plan,
                                                               also transfer the right to offer subsequent loans under        information will be disclosed to the consumer reporting
   I will make monthly payments based on fixed annual
                                                               the MPN to such purchaser. I always have the right to          agencies unless I enter into a repayment arrangement
   or graduated repayment amounts over a period not
                                                               terminate a lender’s ability to make loans to me under         within 30 days of the date on the notice. The guarantor
   to exceed 25 years. If I make fixed payments,
                                                               this MPN by written notice to the lender that holds my         will give me a chance to ask for a review of the debt(s)
   payments must be at least $50 a month and will be
                                                               MPN. The holder of my loan(s) can help me identify the         before the default is reported. My lender or guarantor,
   more if necessary to repay the loan(s) within the
                                                               lender that holds my MPN.
   required time period. I am only eligible for this plan if                                                                  as applicable, must provide a timely response to a
   (i) at the time I obtain a loan under this MPN I have       17. Loan Discharge – My loan(s) will be discharged             request from any consumer reporting agency regarding
   no outstanding balance on a FFELP loan made before          if acceptable documentation of my death is submitted to        objections I might raise with that agency about the
   October 7, 1998, and (ii) I accumulate outstanding          my lender.                                                     accuracy and completeness of information reported by
   FFELP loans exceeding $30,000.                                                                                             the lender or guarantor.
n Income-Sensitive Repayment Plan – If I choose this           My loan(s) may also be discharged if I become totally
   plan, my monthly payments will be adjusted annually,        and permanently disabled as defined by the Act and meet
   based on my expected total monthly gross income             certain other requirements.
   from all sources. I may call my lender at any time for      My loan(s) will not automatically be discharged in
   more information about this repayment plan option.          bankruptcy. To discharge a loan(s) in bankruptcy,
n Income-Based Repayment Plan (effective July 1,               I must prove undue hardship in an adversary proceeding
   2009) – If I choose this plan, my required monthly          before the bankruptcy court.
20. Special Repayment Arrangements – A Federal               and if I meet all other eligibility requirements under the    NOTE: If at the time I obtain a loan under this MPN I have
Consolidation Loan Program is available under which          Act. If I am in default on a FFELP loan or a Direct loan,     an outstanding balance on a FFELP loan disbursed before
I may consolidate federal education loans received           I am not eligible for forgiveness on that loan(s) unless      July 1, 1993, information on deferment conditions that
from different lenders, the same lender, and/or under        I have made satisfactory repayment arrangements.              apply will be found in my earlier promissory
different federal education loan programs into one                                                                         note materials.
                                                             21. Deferments – Under certain circumstances, I have
loan. Depending on the amount I borrow, this program
                                                             a right to defer (postpone) repayment. The types of           22. Forbearance – If I am unable to make any scheduled
may result in an extension of my repayment period.
                                                             deferments that are available to me generally depend          loan payment(s), the lender may allow me to reduce my
Consolidation permits multiple debts to be combined
                                                             on when I first obtained a FFELP loan. Upon request,          payment amount, to extend the time for making
into one monthly payment. For additional information,
                                                             my lender will provide me with information about the          payments, or to temporarily stop making payments
I should contact my lender or guarantor.
                                                             eligibility requirements for each deferment. If I am in       as long as I intend to repay my loan(s). Allowing me
I may consolidate my FFELP loan(s) into the Direct Loan      default on a loan, I am not eligible for a deferment on       to temporarily delay or reduce loan payments is called
Program to take advantage of the public service loan         that loan.                                                    a forbearance. Interest continues to accrue during a
forgiveness program. This program provides for the                                                                         forbearance period.
                                                             Deferment of repayment for loans made under this MPN
cancellation of the remaining balance due on eligible
                                                             is available while I am:                                      The lender may grant me forbearance due to poor health
Direct Loan Program loans after I have made 120
                                                             n Enrolled at least half time at an eligible school,          or other acceptable reasons.
payments (after October 1, 2007) on those loans under
                                                             n Engaged in a full-time course of study in a graduate
certain repayment plans while employed in certain public                                                                   My lender is generally not required to grant a
                                                                fellowship program,
service jobs.                                                                                                              forbearance and may require me to provide my
                                                             n Engaged in a full-time rehabilitation training program
                                                                                                                           reasons for the request and other information.
I may also consolidate my FFELP loans first disbursed on        for individuals with disabilities (if the program is
or after October 1, 2008 (including Federal Consolidation       approved by the Department of Education),                  The lender may grant me a forbearance to eliminate
Loans that repaid FFELP or Direct Loan Program loans         n Conscientiously seeking, but unable to find, full-time      a delinquency that persists even though I am making
first disbursed on or after October 1, 2008) into the           employment (for up to three years),                        scheduled installment payments. My lender may grant
Direct Loan Program to take advantage of the no accrual      n Experiencing an economic hardship as determined by          me an administrative forbearance for up to 60 days in
of interest benefit for active duty service members. No         federal law (for up to three years),                       order to collect and process documentation supporting
interest will be charged on the portion of my Direct         n Serving on active duty during a war or other military       my request for a deferment, forbearance, change in
Consolidation Loan that repaid FFELP or Direct Loan             operation or national emergency or performing              repayment plan, consolidation, or discharge.
Program loans first disbursed on or after October 1,            qualifying National Guard duty during a war or other
                                                                                                                          Circumstances that require my lender to grant me a
2008 during periods of qualifying active duty military          military operation or national emergency and, if I was
                                                                                                                          forbearance, if I provide appropriate documentation,
service (for up to 60 months).                                  serving on or after October 1, 2007, for an additional
                                                                                                                          include:
                                                                180-day period following the demobilization date for
The Act may provide for certain loan forgiveness or                                                                       n Serving in a medical or dental internship or
                                                                my qualifying service, or
repayment benefits on my loans in addition to the                                                                            residency program, if I meet certain criteria.
benefits described in this MPN. If other forgiveness or      n If I am a member of the National Guard or other
                                                                                                                          n Serving in a national service position for which I
repayment options become available, my loan holder will         reserve component of the U.S. Armed Forces (current
                                                                                                                             receive a national service education award under the
provide information about these benefits.                       or retired) and I am called or ordered to active duty
                                                                                                                             National and Community Service Trust Act of 1993.
                                                                while I am enrolled at least half time at an eligible
                                                                                                                             In some cases, the interest that accrues on a qualified
In addition, volunteers who complete service in an              school or within 6 months of having been enrolled at
                                                                                                                             loan during the service period will be paid by the
approved national or community service project can              least half time, a deferment is available during the
                                                                                                                             Corporation for National and Community Service.
earn an educational award. The award can be used to             13 months following the conclusion of my active duty
                                                                                                                          n Qualifying for partial repayment of my loans under
repay a Federal Stafford Loan. If I receive an educational      service, or until I return to enrolled student status on
                                                                                                                             the Student Loan Repayment Program, as
award, I am responsible for providing my lender with            at least a half-time basis, whichever is earlier.
                                                                                                                             administered by the Department of Defense.
information and documentation regarding my term of
service and the award.                                       For in-school deferments, my lender will process             n Qualifying for loan forgiveness under the Teacher
                                                             the deferment based on (i) my request along with                Loan Forgiveness Program, if I meet certain criteria
Other agencies of the federal government may also            documentation verifying my eligibility, or (ii) the             (for up to five years).
offer student loan repayment programs as an incentive        lender’s receipt of a school certification of eligibility in n Having a monthly debt burden for Title IV loans
to recruit and retain employees. I should contact            connection with a new loan, or (iii) the lender’s receipt of    that collectively equals or exceeds 20% of my total
the agency’s human resources department for                  student status information indicating that I am enrolled        monthly gross income (for up to three years).
more information.                                            on at least a half-time basis. If my lender processes        n Being called to active duty in the U.S. Armed Forces.
                                                             a deferment based on (ii) or (iii), I will be notified of
Under certain circumstances, military personnel may                                                                       For additional information, I should contact my lender.
                                                             the deferment and will have the option of canceling the
have their federal education loan(s) repaid by the
                                                             deferment and continuing to make payments on
Secretary of Defense. I should address any questions to                                                                                 Repayment information follows
                                                             my loans.
the local service recruiter. This is a recruiting program
and does not pertain to prior service individuals or those   For all other deferments, I must provide my lender with a
not eligible for enlistment in the Armed Forces.             deferment request (or, for a deferment based on active
                                                             duty or qualifying National Guard duty during a war
If I did not have an outstanding balance on a FFEL or
                                                             or other military operation or national emergency, a
Direct Loan Program loan on October 1, 1998, or if
                                                             representative may request the deferment on my behalf).
I did not have an outstanding balance on the date
                                                             I must also provide information and documentation that
I obtained a loan after October 1, 1998, I may be
                                                             establishes my eligibility, except in certain circumstances
eligible for teacher loan forgiveness. The Department
                                                             when my lender may establish my eligibility by confirming
of Education will repay a fixed amount of my subsidized
                                                             that I have received a deferment on another FFELP loan or
and unsubsidized Federal Stafford loans if I have worked
                                                             on a Direct Loan.
as a full-time teacher for five consecutive school years,
Repaying Your Loans

Follow these steps to estimate your loan payment.


 Step 1: Calculate Your Monthly Interest Charges                                               Approximate Monthly Interest
 Round your Federal Stafford Loan balance up to the nearest           Loan         6.80%            6.00%           5.00%      4.00%               3.40%
 $500. If your loan amount is not on the table, follow the           Amount
 example below to estimate your monthly accrued interest.
                                                                     $    500      $    2.83        $       2.50    $   2.08   $       1.67       $     1.42
 Example:                                                            $ 1,000       $ 5.67           $ 5.00          $ 4.17     $    3.33          $     2.83
 Federal Stafford Loan of $5,479 at 6.8% interest.
                                                                     $ 3,000       $ 17.00          $ 15.00         $ 12.50    $   10.00          $     8.50
 Round up to nearest $500 = $5,500.
                                                                     $ 5,000       $ 28.33          $ 25.00         $ 20.83    $   16.67          $    14.17
        $5,000 = $28.33/month                                        $ 6,000       $ 34.00          $ 30.00         $ 25.00    $   20.00          $    17.00
         + 500 = 2.83/month
                                                                     $ 7,000       $ 39.67          $ 35.00         $ 29.17    $   23.33          $    19.83
        $5,500 = $31.16/month
                                                                     $ 9,000       $ 51.00          $ 45.00         $ 37.50    $   30.00          $    25.50
 Your monthly interest $                     .                       $10,000       $ 56.67          $ 50.00         $ 41.67    $   33.34          $    28.34
                                                                     $15,000       $ 85.00          $ 75.00         $ 62.50    $   50.00          $    42.50
                                                                     $20,000       $113.33          $100.00         $ 83.33    $   66.67          $    56.67
                                                                     $25,000       $141.67          $125.00         $104.17    $   83.33          $    70.83



 Step 2: Estimate Your Capitalized Interest
                                                                          Monthly Interest        Number of Months in                              Estimate of
 Complete this step only if you will not pay accrued                      (From Step One)       Deferment or Forbearance                        Capitalized Interest
 interest for which you are responsible on a
 Federal Stafford Loan. This is an estimate          Example              $     31.16           X              22                  =        $         685.52
 only. Actual interest capitalized will depend on
 factors such as disbursement dates, number of       Your capitalized
                                                     interest             $                     X                                  =        $
 disbursements, and the frequency of capitalization.




 Step 3: Estimate Your Monthly Payment                                                 Estimated Monthly Payments (10-Year Term)
 Round your loan balance up to the nearest $500. If your              Loan          6.80%           6.00%           5.00%      4.00%               3.40%
 principal amount is not on the table, follow the example            Amount
 below to estimate your monthly payment. If you previously
                                                                     $    500      $    5.75        $       5.55    $   5.30   $       5.06        $    4.92
 had interest capitalized, add it to the outstanding loan
 amount to get the new principal amount.                             $ 1,000       $ 11.51          $ 11.10         $ 10.61    $ 10.12             $ 9.84
                                                                     $ 3,000       $ 34.52          $ 33.31         $ 31.82    $ 30.37             $ 29.53
 Example:
 Federal Stafford Loan of $6,185.52 ($5,500 + $685.52)               $ 5,000       $ 57.54          $ 55.51         $ 53.03    $ 50.62             $ 49.21
 at 6.8% interest.                                                   $ 6,000       $ 69.05          $ 66.61         $ 63.64    $ 60.75             $ 59.05
 Round up to nearest $500 = $6,500.                                  $ 7,000       $ 80.56          $ 77.71         $ 74.25    $ 70.87             $ 68.89
        $6,000 = $69.05/month                                        $ 9,000       $103.57          $ 99.92         $ 95.46    $ 91.12             $ 88.58
         + 500 = 5.75/month                                          $10,000       $115.08          $111.02         $106.07    $101.25             $ 98.42
        $6,500 = $74.80/month                                        $15,000       $172.62          $166.53         $159.10    $151.87             $147.62
     Estimated monthly payment = $74.80                              $20,000       $230.16          $222.04         $212.13    $202.49             $196.84
                                                                     $25,000       $287.70          $277.55         $265.16    $253.11             $246.05
 Note: Minimum monthly payment = $50 or amount of interest
 accruing each month.

                                        Loan                  Estimate of Capitalized                   New Principal                    Estimated
                                       Amount                Interest (From Step Two)                     Balance                      Monthly Payment

 Example                          $     5,500            +       $    685.52                    =       $ 6,185.52                      $        74.80


 Your Monthly Payment             $                      +       $                              =       $                               $
Federal Family Education Loan Program (FFELP)                                                                                  Guarantor, Program, or Lender Identification                                OMB No. 1845-0006
                                                                                                                                                                                                           Form approved

Federal Stafford Loan
                                                                                                                                                                                                           Exp. date 07/31/2011



School Certification
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any accompanying docu-
ment is subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.
 (Reserved for school, lender, or guarantor mailing address as appropriate)                                                    1. School Code


                                                                                                                               2. School Information (Name, Address, and Phone Number)




Borrower Information (To be completed by a financial aid administrator or other school official authorized to certify financial aid forms. See the instructions for completing this form on the next page.)
  3. Last Name                                                                                       First Name                                  MI                               4. Social Security Number



  5. Permanent Address (See instructions.)                                                                                      6. Area Code/Telephone Number                     7. Date of Birth (mm-dd-yyyy)



     City                                                            State                           Zip Code                  8. E-mail Address



  9. Lender Name/Lender Code, if known                                                                                         City                            State



10. Grade Level                                                 11. Enrollment Status (Check one)                              12. Anticipated Graduation (Completion) Date (mm-dd-yyyy)

                                                                	 r Full Time                    r At Least Half Time

13. Loan Period (mm-dd-yyyy)                                                                                                   14. Certified Loan Amounts

     From:                                                           To:                                                              a. Subsidized   $                 .00       b. Unsubsidized      $                     .00

15. Recommended Disbursement Date(s) (mm-dd-yyyy)

     1st                                       2nd                                        3rd                                   4th                               5th                            6th

This space reserved for additional disbursement dates, if needed.




School Certification
 I certify:
 • That the borrower named on this Certification is accepted for enrollment in an eligible program on at least a half-time basis; is a U.S. citizen, permanent resident, or other eligible
   non-citizen; and is making satisfactory academic progress;
 • That the borrower is an eligible borrower in accordance with the Higher Education Act of 1965, as amended, and applicable U.S. Department of Education regulations (collectively
   referred to as the Act), that the borrower’s eligibility for a Federal Pell Grant has been determined, and that the borrower has been determined eligible for a loan(s) in the amount(s) certified;
 • That the disbursement schedule complies with the requirements of the Act;
 • Based on available records and appropriate inquiry, that:
  (i) the borrower has met the requirements of the Selective Service Act;
  (ii) the borrower is not incarcerated;
  (iii) the borrower is not liable for an overpayment of any federal grant or loan under the Act;
  (iv) the borrower is not in default on any Title IV education loan(s); or, if the borrower is in default, satisfactory repayment arrangements have been made with the holder(s) of any
  defaulted loan(s);
  (v) the borrower has not been convicted of or pled nolo contendere (no contest) or guilty to a crime involving fraud in obtaining funds under Title IV of the Act; or, if the borrower has pled
  nolo contendere or guilty to such a crime, the borrower has repaid the funds to the Secretary of Education or to the loan holder in the case of a Title IV federal student loan;
  (vi) the borrower does not have property subject to a judgment lien for a debt owed to the U.S.; and
  (vii) the information provided in this Certification is true, complete, and accurate to the best of my knowledge and belief.
 I agree to provide the borrower with (i) confirmation of any transfer of funds through electronic funds transfer (EFT) or master check to the borrower’s student account, and
 (ii) an opportunity to cancel or reduce any disbursement of a loan.


 16. Signature of Authorized School Official ____________________________________________________________                                                 17. Today’s Date (mm-dd-yyyy) _______________________________

      Name/Title (Printed or Typed) ____________________________________________________________________
Instructions for Completing Federal Stafford Loan School Certification
Important Notice: If certification information is transmitted electronically, do not complete the School Certification form.
Enter dates as month-day-year (mm-dd-yyyy). Use only numbers. Example: June 24, 1982 = 06-24-1982.

Item 1: Enter the code for your school.                    Code     Grade Level                                        Item 14a: Enter the lesser of the borrower’s
This code is provided by the U.S. Department               1        Freshman/First-Year (including proprietary         eligibility for a subsidized Federal Stafford Loan
of Education for the Federal Family Education                       school programs that are less than one             or the subsidized Federal Stafford Loan amount
Loan Program.                                                       year in duration)                                  requested by the borrower. If the borrower is not
                                                                                                                       eligible for a subsidized Federal Stafford Loan,
Item 2: Enter your school name and address, and            2        Sophomore/Second-Year
                                                                                                                       enter 0.
the telephone number, including area code, of a            3        Junior/Third-Year
school official who can answer questions about                                                                         Item 14b: Enter the lesser of the borrower’s
                                                           4        Senior/Fourth-Year
this certification.                                                                                                    eligibility for an unsubsidized Federal Stafford Loan
                                                           5        Fifth-Year/Other Undergraduate (including          or the unsubsidized Federal Stafford Loan amount
Item 3: Enter or correct the borrower’s last name,                  sixth-year undergraduate and continuing            requested by the borrower. If the borrower is not
first name, and middle initial.                                     education students)                                eligible for an unsubsidized Federal Stafford Loan,
Item 4: Enter or correct the borrower’s Social             A        First-Year Graduate or Professional                enter 0.
Security Number. This loan cannot be processed             B        Second-Year Graduate or Professional               Item 15: Enter the disbursement dates for this
without the borrower’s Social Security Number.
                                                           C        Third-Year Graduate or Professional                loan(s) as determined in accordance with the Act.
Item 5: Enter the borrower’s permanent address             D        Beyond Third-Year Graduate or Professional         Item 16: Your signature acknowledges that you
(number, street, apartment number) or rural route
                                                           Item 11: Indicate whether the borrower is (or               have read and agree to the provisions in the School
number and box number, then city, state, and zip
                                                           plans to be) enrolled at least half time or full time.      Certification. You must sign the Certification and
code. If the borrower’s mailing address is a post
                                                           A borrower who is enrolled (or planning to enroll)          print your name and title.
office box or general delivery, list both the mailing
address and the street address or rural route number       less than half time is not eligible for a Federal           Item 17: Enter the date of certification.
and box number. If the borrower does not have a            Stafford Loan.
permanent street address or rural route number and         Item 12: Enter the date the borrower is expected
box number, provide the physical location of the           to complete the program at your school. If you are          Paperwork Reduction Notice
borrower’s residence. A temporary school address is        unsure of the actual completion date in the future,
not acceptable.                                                                                                        According to the Paperwork Reduction Act of 1995,
                                                           enter the last day of the month.                            no persons are required to respond to a collection of
Item 6: Enter the borrower’s area code and telephone       Item 13: Enter the dates covered by the cost of             information unless it displays a currently valid OMB
number. If the borrower does not have a telephone,         attendance. These dates must coincide with actual           control number. The valid OMB control number for
enter N/A.                                                 term starting and ending dates. At a school without         this information collection is 1845-0006. The time
                                                           academic terms, these dates must coincide with the          required to complete this information is estimated
Item 7: Enter the date of the borrower’s birth.
                                                           borrower’s program of study if that is                      to average 0.15 hours (9 minutes) per response,
Be careful not to enter the current year.
                                                           less than an academic year in length, or the                including the time to review instructions, search
Item 8: Enter the borrower’s e-mail address,               academic year.                                              existing data resources, gather and maintain the data
if known.                                                                                                              needed, and complete and review the information
                                                           Item 14: Enter the lesser of the amount of the              collection. If you have any comments concerning
Item 9: Enter the borrower’s lender selection (name,       borrower’s eligibility for each loan type, or the           the accuracy of the time estimate(s) or suggestions
identification number, city, and state), if known.         loan amount requested by the borrower. An                   for improving this form, please write to:
Item 10: Enter the grade level of the borrower. Select     undergraduate borrower’s eligibility must be reduced
                                                           if the borrower is attending a program with a length        U.S. Department of Education
the proper grade level indicator using the standard
                                                           of less than a full academic year, or completing the        Washington, DC 20202-4537
grade level codes provided:
                                                           remaining balance of a program in a period of less
                                                           than an academic year. The borrower’s eligibility may
                                                           also be reduced based on professional judgment. If
                                                           this field is left blank, the loan(s) will be delayed.
                  Addendum to the Federal PLUS Loan Application and Master Promissory Note and Endorser Addendum
                                              Federal Family Education Loan Program
The Higher Education Reconciliation Act of 2005, the College Cost Reduction and Access Act of 2007,           • MPN: Governing Law and Notices. This item is revised to include the following statement:
the Ensuring Continued Access to Student Loans Act of 2008, the Higher Education Opportunity Act of              “Information about my loan(s) will be submitted to the National Student Loan Data System
2008, and regulations issued by the U.S. Department of Education (the Department) on November 1,                 (NSLDS). Information in NSLDS is accessible to schools, lenders, and guarantors for specific
2007 and October 23, 2008 changed some of the terms of Federal PLUS Loans made under the                         purposes as authorized by the Department.”
Federal Family Education Loan Program (FFELP). As a result, certain terms of the loan(s) you receive          • Borrower’s Rights and Responsibilities Statement: Item 5, Loan Fees. This item is revised to
under the accompanying Federal PLUS Loan Application and Master Promissory Note (MPN) or                         read as follows: “I may be charged an origination fee and/or a federal default fee for each loan
endorse under the accompanying Endorser Addendum to Federal PLUS Loan Application and Master
                                                                                                                 made under this MPN. Neither fee may exceed the rate as specified in the Act. If I am charged
Promissory Note (Endorser Addendum) differ from the terms in the MPN, Endorser Addendum, and                     these fees, they will be deducted proportionately from each disbursement.” NOTE: Any reference to
Borrower’s Rights and Responsibilities Statement. This Addendum describes the changes made to the                a guarantee fee in the MPN is deemed to be a reference to the federal default fee.
loan terms by the laws and regulations listed above. Your loan is subject to these changes. The
changes set forth in this Addendum are incorporated into and made a part of the accompanying MPN              • Borrower’s Rights and Responsibilities Statement: Item 6, Disbursement of Loan Money.
or Endorser Addendum that you sign and the Borrower’s Rights and Responsibilities Statement.                     Loan money for students enrolled in foreign schools must be sent to the school, and generally must
                                                                                                                 be disbursed in multiple installments.
• Graduate and Professional Students May Borrow PLUS Loans. A graduate or professional
   student may borrow a Federal PLUS Loan. Before applying for a Federal PLUS Loan, a graduate or             • Borrower’s Rights and Responsibilities Statement: Item 9, Interest Rates. Effective for loans
   professional student must first complete the Free Application for Federal Student Aid (FAFSA) and             first disbursed on or after July 1, 2006, a Federal PLUS Loan has a fixed interest rate. In addition,
   must have been determined eligible for his or her maximum loan amount under the Federal Stafford              the following sentences are added: “If I qualify under the Servicemembers Civil Relief Act, the
   Loan Program. Except as provided in this Addendum, the terms and conditions of the Federal PLUS               interest rate on my loans obtained prior to military service may be limited to 6% during my military
   Loan as described in the accompanying MPN and Borrower’s Rights and Responsibilities                          service. To receive this benefit, I must contact my loan holder for information about the
   Statement apply regardless of whether the borrower is a parent or a graduate or professional                  documentation I must provide to show that I qualify.”
   student.                                                                                                   • Borrower’s Rights and Responsibilities Statement: Item 10, Payment of Interest. The second
                                                                                                                 sentence of the second paragraph is revised to read as follows: “This interest (for example, interest
The following changes apply only to graduate and professional student Federal PLUS Loan
                                                                                                                 that accrues during an in-school deferment) may be paid or capitalized (added to the principal of my
borrowers and to endorsers of Federal PLUS Loans made to graduate and professional student
borrowers:                                                                                                       loan(s)).”

• General Changes. If you are a graduate or professional student, all references to “student,”                • Borrower’s Rights and Responsibilities Statement: Item 11, Loan Cancellation. The second
   “dependent student,” “dependent” or “parent” throughout the MPN refer to you. If you are an                   bullet is revised to read as follows: “If the school receives the money by EFT or master check and
   endorser for a graduate or professional student Federal PLUS Loan borrower, all references to                 has obtained my written confirmation of the types and amounts of federal student loans that I want
                                                                                                                 to receive before crediting the loan funds to my or the student’s account, I may cancel all or part of
   “student,” “dependent student,” or “parent” throughout the Endorser Addendum refer to the student
   borrower.                                                                                                     the loan by informing the school within 14 days after the date the school notifies me of my right to
                                                                                                                 cancel the loan, or by the first day of the school’s payment period, whichever is later. (The school
• MPN: Borrower (Parent) Section and Student Information Section. If you are a graduate or                       can tell me the first day of the payment period.) If the school has not obtained my written
   professional student, provide information about yourself in both the “Borrower (Parent) Section” and          confirmation of the loans I want to receive, I may cancel all or part of the loan by informing the
   the “Student Information Section” of the MPN. Do not leave any items blank.                                   school within 30 days of the date the school notifies me of my right to cancel the loan. If I cancel all
• Endorser Addendum: Section B., Loan Description. If you are an endorser for a graduate or                      or a portion of a loan as described in this paragraph, the school will return the cancelled amount to
   professional student Federal PLUS Loan borrower, provide information about the student in both                my lender, and the loan fees will be eliminated or reduced in proportion to the amount returned.”
   the parent borrower items (12, 13 and 15) and the student items (16 and 17).                               • Borrower’s Rights and Responsibilities Statement: Item 13, Sale or Transfer of Loan(s). The
• MPN: Borrower Request, Certifications, and Authorizations. If you are a graduate or                            second sentence is revised to read as follows: “If ownership of a loan is transferred and the entity to
   professional student, paragraph 18.B. does not apply, and paragraph 18.C. is revised to read as               which I must make payments changes, I will be notified of that entity’s name, address and
   follows: “Loan proceeds will be used for authorized educational costs, and I will immediately repay           telephone number, the effective date of the sale or transfer, and the date when I must begin
   any loan proceeds that cannot be attributed to educational costs for attendance on at least a half-           sending payments to that entity.”
   time basis at the school that certified my loan eligibility.”                                              • Borrower’s Rights and Responsibilities Statement: Item 14, Loan Discharge. A loan is eligible
• MPN: Promise to Pay. If you are a graduate or professional student, the second sentence of                     for discharge if it is determined that the borrower’s eligibility for the loan was falsely certified as a
   paragraph 20 is revised to read as follows: “I understand that multiple loans may be made to                  result of a crime of identity theft. In addition, the second paragraph is revised to read as follows: “My
   me under this MPN.”                                                                                           loan(s) may also be discharged if I become totally and permanently disabled as defined by the Act
                                                                                                                 and meet certain other requirements.”
• Borrower’s Rights and Responsibilities Statement: Item 12, Repayment. Effective July 1, 2009,
   an Income-Based Repayment Plan is available to eligible graduate and professional student                  • Borrower’s Rights and Responsibilities Statement: Item 17, Special Repayment
   Federal PLUS Loan borrowers. Under this plan, the required monthly payment amount will be                     Arrangements. A married couple may no longer borrow a Federal Consolidation Loan as joint
   based on a borrower’s income during any period when the borrower has a partial financial hardship.            borrowers. A borrower may consolidate his or her FFELP loans into the William D. Ford Federal
   The maximum repayment period under this plan may exceed 10 years. Eligible borrowers who meet                 Direct Loan (Direct Loan) Program to take advantage of the public service loan forgiveness
   certain requirements over a 25-year period may qualify for cancellation of any outstanding balance            program. This program provides for the cancellation of the remaining balance due on eligible Direct
   on their loans.                                                                                               Loan Program loans after the borrower has made 120 payments (after October 1, 2007) on those
                                                                                                                 Direct Loans under certain repayment plans while the borrower is employed in certain public service
The following change applies only to parent Federal PLUS Loan borrowers:                                         jobs.
• Effective for loans first disbursed on or after July 1, 2008, parent borrowers of PLUS loans may               A borrower may also consolidate his or her FFELP loans first disbursed on or after October 1, 2008
   request that repayment of loan principal be deferred while the student on whose behalf the loan was           (including Federal Consolidation Loans that repaid FFELP or Direct Loan Program loans first
   obtained is enrolled on at least a half-time basis and for the 6-month period after the student ceases        disbursed on or after October 1, 2008) into the Direct Loan Program to take advantage of the no
   to be enrolled at least half time. Interest will continue to be charged on the loan during this period.       accrual of interest benefit for active duty service members. No interest will be charged on the
                                                                                                                 portion of a Direct Consolidation Loan that repaid FFELP or Direct Loan Program loans first
The following changes apply to all Federal PLUS Loan borrowers:                                                  disbursed on or after October 1, 2008 during periods of qualifying active duty military service (for up
• MPN: Borrower Request, Certifications, and Authorizations. The first sentence of paragraph                     to 60 months).
   19.E. is revised to read as follows: “I may tell my lender that I want to pay the interest that accrues,      The Act may provide for certain loan forgiveness or repayment benefits on a borrower’s FFELP
   including interest that accrues during an in-school deferment.”                                               loans in addition to the benefits described in this MPN. If other forgiveness or repayment options
• MPN: Borrower Request, Certifications, and Authorizations. Paragraph 19.H. is revised to read                  become available, a borrower’s loan holder will provide information about these benefits.
   as follows: “I authorize my lender to defer repayment of principal on my loan(s) based on enrollment       • Borrower’s Rights and Responsibilities Statement: Item 18, Deferments. A deferment is
   on at least a half-time basis and, if I am a graduate or professional student, for the 6-month period         available for a period during which a borrower is serving on active duty during a war or other military
   after I cease to be enrolled at least half time.”                                                             operation or national emergency, or performing qualifying National Guard duty during a war or other
• MPN: Borrower Request, Certifications, and Authorizations. By signing your MPN you are                         military operation or national emergency, and if the borrower is serving on or after October 1, 2007,
   certifying, under penalty of perjury, that if you have been convicted of, or have pled nolo contendere        for an additional 180-day period following the demobilization date for the qualifying service. A
   or guilty to, a crime involving fraud in obtaining federal student assistance under Title IV of the           borrower who is a member of the National Guard or other reserve component of the U. S. Armed
   Higher Education Act of 1965, as amended, you have completed the repayment of such funds to                   Forces (current or retired) and who is called or ordered to active duty while enrolled at least half
   the Department, or to the loan holder in the case of a Title IV federal student loan.                         time at an eligible school, or within 6 months after having been enrolled at least half time, is eligible
                                                                                                                 for a deferment during the 13 months following the conclusion of the active duty service, or until the
   If you are a parent applying for a Federal PLUS Loan for a dependent undergraduate student, you               date the borrower returns to enrolled student status on at least a half-time basis, whichever is
   are not eligible for a Federal PLUS Loan if that student has been convicted of, or has pled nolo              earlier.
   contendere or guilty to, a crime involving fraud in obtaining federal student assistance under Title IV
   of the Higher Education Act of 1965, as amended, unless that student has completed the                        For loans first disbursed on or after July 1, 2008, parent borrowers may request a deferment while
   repayment of such funds to the Department, or to the loan holder in the case of a Title IV federal            the student for whom a loan was obtained is enrolled on at least a half-time basis, and during the 6-
   student loan.                                                                                                 month period after the student or the parent ceases to be enrolled at least half time.
• MPN: Repayment. Effective July 1, 2009, the second sentence of the second paragraph is revised
   to read as follows: “My principal repayment period for each loan, exclusive of any period(s) of
   deferment or forbearance, generally lasts 5 years but may not exceed 10 years (except under an
   extended or income-based repayment plan).”

                                                                                                                                                                            To be used with OMB No. 1845-0069
                                                                                                                                                                                            Exp. Date 3/31/2008
                                                                                 Federal PLUS Loan Plain Language Disclosure

A graduate or professional student or the parent of a dependent undergraduate student may borrow               Interest is charged on the unpaid principal amount. Interest charges begin on the date the loan is
a PLUS Loan. In this document “you” refers to the borrower. This Disclosure summarizes information             disbursed and end when the loan is paid in full. You must pay all interest charges on your Federal
concerning your loan. Please refer to your Federal PLUS Loan Master Promissory Note (MPN),                     PLUS Loan. You agree that the lender may add interest charges to your loan amount, as provided
Borrower’s Rights and Responsibilities Statement, and loan-specific disclosure for the complete terms          by law, if you do not make payments of interest.
and conditions of your loan. Except as specifically stated in this Disclosure, those documents govern
the terms and conditions of your loan.                                                                         10. Late Charges and Collection Costs - Your lender may collect a late charge from you if you
                                                                                                               do not make any part of a payment within 15 days after it is due. Your lender may only collect one
Please read this Disclosure carefully, print the document if it has been delivered in an electronic form,      late charge for each payment, no matter how many days the payment is late. Your lender may also
and maintain a hard copy in a safe place. If you have questions about your loan, contact your lender.          collect from you certain limited charges and fees involved in collecting your loan in accordance with
                                                                                                               the Department’s regulations.
1. General - You are receiving a Federal PLUS Loan to help cover the costs of your education or
your dependent undergraduate student’s education. You must repay this loan. You are responsible                11. Loan Consolidation - You may be eligible to consolidate all of your eligible federal education
for repaying this loan even if you or your dependent student are dissatisfied with the education               loans into one loan. Consolidating your loans may give you up to 30 years to pay them back and
provided by the school, do not complete the program of study, or cannot find work in that area                 may lower your monthly payments; however, you may be repaying your loans for a longer period
of study. Borrow only the amount you need.                                                                     and pay more interest. Contact your lender for more information about consolidating your loans.
By accepting your loan proceeds, you are certifying, under penalty of perjury, that if you or your             12. Deferments - You do not have to make payments in certain circumstances. For example: You
dependent undergraduate student, as applicable, have been convicted of, or have pled nolo                      may defer repayment for up to 3 years while you are unemployed.
contendere or guilty to, a crime involving fraud in obtaining federal student assistance under Title IV
of the Higher Education Act of 1965, as amended (the Act), you, or the student, have completed the             You may defer repayment while you are enrolled at least half time at an eligible school and, for loans
repayment of such funds to the U.S. Department of Education (the Department) or to the loan holder             first disbursed on or after July 1, 2008, during the 6-month period after you cease to be enrolled at
in the case of a Title IV federal student loan.                                                                least half time. If you are a parent borrower, you may request that repayment of principal for loans
                                                                                                               first disbursed on or after July 1, 2008 be deferred while the student for whom you obtained the loan
Information about your loan(s) will be submitted to the National Student Loan Data System (NSLDS).             is enrolled at least half time at an eligible school, and for the 6-month period after the student ceases
Information in NSLDS is accessible to schools, lenders, and guarantors for specific purposes as                to be enrolled at least half time.
authorized by the Department.
                                                                                                               A deferment is also available while you are serving on active duty during a war or other military
2. Loan Cancellation - Before your lender sends your loan money to the school, you may cancel or               operation or national emergency, or performing qualifying National Guard duty during a war or other
reduce the amount of your loan by writing to the school or your lender. After your loan money is sent          military operation or national emergency and if you are serving on or after October 1, 2007, for an
to the school, you may cancel all or part of your loan by notifying the school within certain time frames.     additional 180-day period following the demobilization date for your qualifying service. If you are a
If the school has obtained your written confirmation of the types and amounts of loans you want to             member of the National Guard or other reserve component of the U.S. Armed Forces (current or
receive before crediting the loan funds to your or your dependent student’s account, you may cancel            retired) and you are called or ordered to active duty while you are enrolled at least half time at an
all or a part of that loan by informing the school within 14 days after the date the school notifies you       eligible school, or within 6 months of having been enrolled at least half time, you are eligible for a
of your right to cancel the loan, or by the first day of the school’s payment period, whichever is later. If   deferment during the 13 months following the conclusion of your active duty service, or until the
the school has not obtained your written confirmation of the loans you want to receive, you may cancel         date you return to enrolled student status on at least a half-time basis, whichever is earlier.
all or part of the loan by informing the school within 30 days of the date the school notifies you of your
right to cancel the loan. If you cancel all or a portion of a loan as described in this paragraph, the         This is not a complete list of available deferments. For a complete list of deferments, and
school will return the cancelled amount to your lender, and the loan fees will be eliminated or reduced        all documentation and eligibility requirements, please refer to your Borrower’s Rights and
in proportion to the amount returned. You may also pay back all or a part of your loan within 120 days         Responsibilities Statement and any supplemental information you may receive.
of the date your lender sends your loan money to the school, and your loan fees will be eliminated or          You must pay the interest on a PLUS Loan during deferment periods, or it will be added to the
reduced.                                                                                                       principal amount of the loan. If interest is added to the principal amount, you will then pay interest
3. Federal PLUS Loan MPN - If you are a parent borrowing for more than one dependent                           on the larger amount. Having interest added to the principal amount may also cause your monthly
undergraduate student, you need a separate MPN for each student. If you are borrowing for yourself             payment amount to increase.
as a graduate or professional student and also as a parent for one or more dependent undergraduate             13. Forbearance - If you cannot make scheduled payments and do not qualify for a deferment, your
students, you need one MPN to borrow for yourself as the student and a separate MPN to borrow for              lender may allow you to temporarily make smaller payments or temporarily stop making payments.
each dependent student.                                                                                        This is called a forbearance. Interest will be charged on your loan during a forbearance. The lender
If you or your dependent student continue to attend a participating school located in the United States,       must grant you a forbearance in certain cases, as described in your Borrower’s Rights and
you may receive multiple loans for yourself or your dependent student, as applicable, under the same           Responsibilities Statement.
MPN (as explained above) for up to 10 years. You may write to your lender to stop loans from being             14. Loan Discharge - Your loan will be discharged (forgiven) when (i) acceptable documentation
made under your MPN. You will need to sign a new MPN if you want to change your lender or if you               of your death, or your dependent’s death, is given to your lender, (ii) you or your dependent cannot
or your dependent student transfer between a Federal Family Education Loan Program (FFELP)                     complete a course of study because the school closes, (iii) the school falsely certifies your loan
school and a William D. Ford Federal Direct Loan (Direct Loan) Program school.                                 eligibility, (iv) a loan in your name was falsely certified as a result of a crime of identity theft, or
4. Loan Amount - The total amount you borrow each academic year cannot be more than the cost                   (v) you become totally and permanently disabled and meet certain other requirements. Your loan
of attendance minus any financial aid that has been or will be awarded for the period of enrollment for        may also be discharged up to the amount of any refund that the school should have made, but did
which the loan is intended. The school determines the cost of attendance using federal guidelines.             not send to your lender. Your loan will not automatically be discharged in bankruptcy.

5. Use of Loan Money - The loan money you borrow may only be used to pay educational expenses                  15. Consumer Reporting Agency Notification - Information about your loan will be reported to
(e.g., tuition, room, board, books) for yourself (if you are a graduate or professional student borrower),     national consumer reporting agencies. Information will include the disbursement date, amount, and
or for the dependent undergraduate student (if you are a parent borrower) at the school that certified         repayment status of your loan (for example, whether you are current or behind schedule in making
your eligibility. If you accept this loan, eligibility for other student assistance may be affected.           payments).

6. Origination Fee and Federal Default Fee - Federal law requires an origination fee and a federal             16. Default and Acceleration - If you default on your loan, that fact will be reported to all national
default fee for each loan made under the MPN. (Before July 1, 2006, the federal default fee was                consumer reporting agencies. All unpaid amounts and collection fees on your loan will become
called a guarantee fee or insurance premium.) The law specifies the maximum amount of each fee                 immediately due and payable. You may be sued, your wages may be garnished, you may lose
and authorizes both fees to be deducted from your loan amount.                                                 federal payments, and/or your tax refund may be withheld. You agree to pay reasonable collection
                                                                                                               fees and costs, plus court costs and attorney fees. You may face other serious consequences.
7. Change of Status or Address - You must tell the school and/or your lender if you or your
dependent student stops attending school, no longer attends school on at least a half-time basis,              17. Sale or Transfer of Your Loan - Your lender may sell or assign this loan without your consent
or transfers to another school. You must also tell your lender any time you change your address,               and without selling or assigning any of your other loans. The sale or transfer of your loan does not
telephone number, e-mail address, name (e.g., maiden name to married name) or employer, or                     affect your rights and responsibilities with respect to the loan. If ownership of a loan is transferred
if the address or telephone number of your employer changes at any time.                                       and the entity to which you must make payments changes, you will be notified of that entity’s name,
                                                                                                               address and telephone number, the effective date of the sale or transfer, and the date when you
8. Repayment - You must repay the full loan amount, and all interest on your loan, generally within            must begin sending payments to that entity.
10 years. The repayment period for your loan begins on the date of the final disbursement. Unless
payments are deferred, your first payment will be due within 60 days of your final disbursement. (See          18. Department of Defense Repayment Program - Under certain circumstances, military personnel
Item 12 of this Disclosure for deferment information.)                                                         may have their loan(s) repaid by the Secretary of Defense. You should address any questions you
                                                                                                               have to the local service recruiter. This is a recruiting program and generally does not pertain to prior
You must make payments according to the schedule provided by your lender. Your lender will give                service individuals or those not eligible for enlistment in the Armed Forces.
you the choice of a Standard Repayment Plan, a Graduated Repayment Plan, an Income-Sensitive
Repayment Plan or, if you are eligible, an Extended Repayment Plan. Effective July 1, 2009, if you             19. Loan Forgiveness for Public Service Employees Program - You may consolidate your FFELP
are a graduate or professional student Federal PLUS Loan borrower and if you are eligible, you may             loans into the Direct Loan Program to take advantage of the public service loan forgiveness program.
also choose an Income-Based Repayment Plan under which your monthly payment will be based on                   This program provides for the cancellation of the remaining balance due on eligible Direct Loan
your income during any period when you are experiencing a partial financial hardship. (Parent Federal          Program loans after you have made 120 payments (after October 1, 2007) on those Direct Loans
PLUS Loan borrowers are not eligible for the Income-Based Repayment Plan.) You may request to                  under certain repayment plans while you are employed in certain public service jobs.
change your repayment plan at any time, but your lender may limit you to one such change each year.            20. No Accrual of Interest for Active Duty Service Members - You may consolidate your FFELP
These plans are designed to give you flexibility in meeting your repayment obligation. You may make            loans first disbursed on or after October 1, 2008 (including Federal Consolidation Loans that repaid
loan payments before they are required, or in amounts greater than required, at any time without               FFELP or Direct Loan Program loans first disbursed on or after October 1, 2008) into the Direct Loan
penalty. When you pay back your loan in full, the current loan holder may send you a notice telling            Program to take advantage of the no accrual of interest benefit for active duty service members. No
you that you have paid off your loan instead of returning the original MPN. You should keep this               interest will be charged on the portion of a Direct Consolidation Loan that repaid FFELP or Direct Loan
notice in a safe place.                                                                                        Program loans first disbursed on or after October 1, 2008 during periods of qualifying active duty
9. Interest - Loans with a first disbursement on or after July 1, 2006, have a fixed interest rate of 8.5%.    military service (for up to 60 months).
Loans made prior to that date have a variable interest rate that may change each year on July 1 and            21. Other Loan Forgiveness and Repayment Benefits - The Act may provide for certain
that will never be more than 9%. If you qualify under the Servicemembers Civil Relief Act, the interest        loan forgiveness or repayment benefits on your loans in addition to the benefits described in
rate on your loans obtained prior to military service may be limited to 6% during your military service.       your MPN. If other forgiveness or repayment options become available, your loan holder will
To receive this benefit, you must contact your loan holder for information about the documentation             provide information about these benefits.
you must provide to show that you qualify.
                                                                                                                                                                                                        Revised 03-27-2009
                                                                                                                                        Guarantor, Program, or Lender Identification
Federal Family Education Loan Program (FFELP)                                                                                                                                                                                    OMB No. 1845-0069
                                                                                                                                                                                                                                 Form approved

Federal PLUS Loan                                                                                                                                                                                                                Exp. date 08/31/2010


Application and Master Promissory Note (MPN)
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any accompanying document is subject
to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.

IMPoRtANt INFoRMAtIoN ABout PRoCeduReS FoR oPeNING A NeW loAN ACCouNt: To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain,
verify, and record information that identifies each person who opens a loan account. What this means for you: Your name, address, date of birth, and other information collected in this form will be used to verify your identity. You may
also be asked to provide your driver’s license or other identifying documents.
Borrower Section                                                                                                                                                  Print using a dark ink ballpoint pen or type. Read the instructions carefully.
CheCK oNe: I am a q Graduate or Professional Student                               q Parent of a dependent undergraduate Student
 1. Last Name                                                                         First Name                                                             MI                           2. Social Security Number


 3. Permanent Address (See instructions.)                                                                                                                                                 4. Area Code/Telephone Number
                                                                                                                                                                                             (             )
    City                                                                              State                             Zip Code                                                          5. Date of Birth (mm-dd-yyyy)


 6. E-mail Address                                                                                                                    7. Driver’s License State and Number
                                                                                                                                          State               #
 8. U.S. Citizenship Status (Check a or b, and if b is checked, list Registration Number.)
     q     a. Citizen/National         q    b. Permanent Resident/Other Eligible Non-Citizen                     If “b,” Alien Registration Number
 9. Lender Name                                                                       City                                             State                  Zip Code                    10. Lender Code, if known


11. Employer Name, Address, City, State, Zip Code                                                                                                                                         12. Work Area Code/Telephone Number
                                                                                                                                                                                                 (             )
13. References: You must provide two separate references with different U.S. addresses who do not live with you and who have known you for at least three years. If you are a parent borrower, do not list the
                 student as a reference.
     Name                                          A.                                                                                                         B.

     Permanent Address

     City, State, Zip Code

     E-mail Address

     Area Code/Telephone Number                         (              )                                                                                             (             )

     Relationship to Borrower

Student Information Section                                                                                                            Complete this section only if you are a parent borrowing for a dependent undergraduate student.
14. Last Name                                                                        First Name                        MI             15. Social Security Number                                          16. Date of Birth (mm-dd-yyyy)


Borrower Request, Certifications, and Authorizations                                                                                                                                                               Read carefully before signing below.
17. Requested loan Amount: This is an MPN for one or more Federal PLUS Loans. I request a Federal PLUS                                    crime involving fraud in obtaining funds under Title IV of the HEA, as amended, the student has completed the
    Loan under this MPN in an amount not to exceed the annual cost of attendance minus other financial                                    repayment of such funds to the Department, or to the loan holder in the case of a Title IV federal student loan.
    aid received for each academic year. For each loan, the school will notify me of the loan amount that I
    am eligible to borrow. I may cancel my loan or request a lower amount by contacting my lender or the                              19. For all PLUS loans (as described in the additional MPN provisions and the Borrower’s Rights and
    school. Additional information about my right to cancel a loan or request a lower amount is included in                               Responsibilities Statement) I receive under this MPN, I make the following authorizations:
    the Borrower’s Rights and Responsibilities Statement and disclosure statements that have been or will be                           A. I authorize the school to certify my eligibility for loans under this MPN.
    provided to me. If I have an adverse credit history and obtain an endorser so that I may receive a PLUS                            B. I authorize the lender, the guarantor, or their agents to investigate my credit record and report information
    Loan, only one loan may be made to me under this MPN.                                                                                 concerning my loan status to persons and organizations permitted by law to receive such information.
                                                                                                                                       C. I authorize the school to transfer loan proceeds received by electronic funds transfer (EFT) or master check
18. Under penalty of perjury, I certify for any loan I receive under this MPN that:                                                       to my account at the school (if I am the student) or to the student’s account at the school (if I am a parent).
 A. The information I have provided on this MPN and as updated by me from time to time is true, complete,                              d. I authorize the school to pay to the lender any refund that may be due up to the full loan amount.
    and correct to the best of my knowledge and belief and is made in good faith.                                                      e. I may tell my lender that I want to pay the interest that accrues, including interest that accrues during an
 B. I am: (i) a graduate or professional student, (ii) the biological or adoptive parent of the dependent                                 in-school deferment. However, in all cases, unless I pay the interest, my lender will add the unpaid interest
    undergraduate student identified in the Student Information Section, or (iii) the spouse of a parent and                              that accrues during forbearance and deferment and other periods on each PLUS Loan made under this MPN
    my income and assets were reported on the Free Application for Federal Student Aid (FAFSA) or would be                                to the principal balance of that loan (capitalization) as provided under the Act. Capitalization will increase the
    reported if a FAFSA were filed.                                                                                                       principal balance on my loan(s) and the total amount of interest costs I must pay.
 C. Loan proceeds will be used for authorized educational costs incurred by me or by the student identified                            F. I authorize the release of information pertinent to my loan(s): (i) by the school(s), the lender(s), and the
    above. I will immediately repay any loan proceeds that cannot be attributed to educational costs for                                  guarantor(s), or their agents to the references on the applicable loan(s) and to members of my immediate
    attendance on at least a half-time basis at the school that certified my loan eligibility.                                            family unless I submit written directions otherwise; and (ii) by and among the school(s), lender(s),
 d. If I owe an overpayment on a Federal Perkins Loan, Federal Pell Grant, Federal Supplemental Educational                               guarantor(s), the Department, and their agents.
    Opportunity Grant, Academic Competitiveness Grant (ACG), National Science and Mathematics Access                                   G. To verify information I provide and so that the loan(s) requested can be approved, I authorize the
    to Retain Talent (SMART) Grant, or Leveraging Educational Assistance Partnership Grant, I have made                                   Department to send any information about me that is under its control, including information from the
    satisfactory arrangements with the holder to repay the amount owed.                                                                   FAFSA, to the school, to the lender, and to state agencies and nonprofit organizations that administer
 e. If I am in default on any loan received under the Federal Perkins Loan Program (including NDSL loans),                                financial aid programs under the FFELP. I understand that information reported on this MPN may be
    the Federal Direct Loan Program, or the Federal Family Education Loan Program (“FFELP” as defined in                                  shared with the Department, and that the Department has the authority to verify that information with
    the Borrower’s Rights and Responsibilities Statement), I have made satisfactory arrangements with the                                 other federal agencies.
    holder to repay the amount owed.                                                                                                   h. I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors
 F. If I have been convicted of, or pled nolo contendere (no contest) or guilty to, a crime involving fraud in                            to contact me regarding my loan request(s) or my loan(s), including repayment of my loan(s), at the current
    obtaining funds under Title IV of the Higher Education Act (HEA) of 1965, as amended, I have completed                                or any future number that I provide for my cellular telephone or other wireless device using automated
    the repayment of such funds to the U.S. Department of Education (the Department), or to the loan holder in                            telephone dialing equipment or artificial or prerecorded voice or text messages.
    the case of a Title IV federal student loan. If I am a parent applying for a Federal PLUS Loan for a dependent                     I. I authorize my lender to defer repayment of principal on my loan(s) based on my enrollment on at least a
    undergraduate student, and if that student has been convicted of, or pled nolo contendere or guilty to, a                             half-time basis and, if I am a graduate or professional student, for the 6-month period after I cease to be
                                                                                                                                          enrolled at least half time.
Promise to Pay                                          In this MPN, “lender” refers to, and this MPN benefits, the original lender and its successors and assigns, including any subsequent holder of this MPN.
20. I promise to pay to the order of the lender all loan amounts disbursed (hereafter “loan” or “loans”) under the terms of this MPN, plus interest and other charges and fees that may become due as provided in this MPN.
    I understand that, if I qualify, more than one loan may be made to me under this MPN for myself or for the student identified in the Student Information Section. I understand that by accepting any disbursement issued
    at any time under this MPN, I agree to repay the loan(s). I understand that, within certain time frames, I may cancel or reduce the amount of any loan by refusing to accept or by returning all or a portion of any disbursement
    that is issued. Unless I make interest payments, interest that accrues on my loan(s) during deferment, forbearance, and other periods may be added as provided under the Act to the principal balance of such loan(s). If I
    do not make any payment on any loan made under this MPN when it is due, I will also pay reasonable collection costs including, but not limited to, attorney fees, court costs, and other fees. I will not sign this MPN before
    reading the entire MPN, even if I am told not to read it, or told that I am not required to read it. I am entitled to a copy of this MPN and the Borrower’s Rights and Responsibilities Statement. My signature certifies I have
    read, understand, and agree to the terms and conditions of this MPN, including the Borrower Request, Certifications, and Authorizations printed above, the Notice about Subsequent Loans Made under This MPN, and the
    Borrower’s Rights and Responsibilities Statement.
     I uNdeRStANd thAt I MAy ReCeIve oNe oR MoRe loANS uNdeR thIS MPN ANd thAt I MuSt RePAy All loANS thAt I ReCeIve uNdeR thIS MPN.

21. Borrower Signature                                                                                                                                                        22. today’s date (mm-dd-yyyy)
                                                                                                                                                                                                                         Additional MPN provisions follow
Federal PLUS Loan Application and Master Promissory Note (MPN)                                                                                             (continued)
Governing law                                                      authorizes both fees to be deducted from my loan amount.          concludes I no longer intend to honor my repayment
   The terms of this MPN will be interpreted in accordance         The fee(s) I am charged, as identified in the disclosure          obligation. If I default, the guarantor may purchase
with the Higher Education Act of 1965, as amended                  statement, will be deducted proportionately from each             my loan(s) and capitalize all outstanding interest into
(20 U.S.C. 1070 et seq.), the U.S. Department of                   disbursement of my loan(s). I understand the origination          a new principal balance. The new principal balance and
Education’s (the Department’s) regulations, as they may be         and federal default fees may be refundable only to the            collection fees will become immediately due and payable.
amended in accordance with their effective date, and other         extent permitted by the Act.                                         If I default, the default will be reported to all national
applicable federal statutes and regulations (collectively                                                                            consumer reporting agencies and will significantly and
referred to as the “Act”), and the guarantor’s policies.           late Charges and Collection Costs                                 adversely affect my credit history. I understand that a
Applicable state law, except as preempted by federal law,              The lender may collect from me: (i) a late charge for         default will have additional adverse consequences to me
may provide for certain borrower rights, remedies, and             each late installment payment if I do not make any part of a      as disclosed in the Borrower’s Rights and Responsibilities
defenses in addition to those stated in this MPN.                  required installment payment within 15 days after the date        Statement. Following default, the loan(s) may be subject to
                                                                   it becomes due, and (ii) any other charges and fees that          income-based or income-contingent repayment (including
disclosure of terms                                                are permitted by the Act for the collection of my loan(s).        potential collection of amounts in excess of the principal
    Loans disbursed under this MPN are subject to the              If I default on any loan(s), I will pay reasonable collection     and interest) in accordance with the Act.
loan limits specified in the Act. Under this MPN, the              fees and costs, plus court costs and attorney fees.
principal amount that I owe and am required to repay, will                                                                           legal Notices
be the sum of all disbursements issued (unless I reduce            Repayment                                                             Any lender holding a loan made under this MPN is
or cancel any disbursements as provided below).                        I must repay the full amount of the loan(s) made under        subject to all claims and defenses that I could assert
    My lender will determine whether to make any loan              this MPN and accrued interest. I will repay the principal         against the school with respect to that loan if (i) the loan
under this MPN after my eligibility is determined by the           of each loan in periodic installments during a repayment          was made by the school or a school-affiliated organization,
school. At or before the time of the first disbursement for        period that begins on the day of the final disbursement for       (ii) the lender who made the loan provided an improper
each loan, a disclosure statement will be provided to me           that loan.                                                        inducement (as defined by the Act) to the school or to any
identifying the amount of the loan and additional terms of             My lender must provide me with a choice of repayment          other party in connection with the making of the loan, (iii)
the loan. Important additional information is also disclosed       plans consistent with the provisions of the Act. My               the school refers loan applicants to the lender, or (iv) the
in the Borrower’s Rights and Responsibilities Statement            repayment period for each loan generally lasts at least           school is affiliated with the lender by common control,
accompanying this MPN. The Borrower’s Rights and                   5 years but may not exceed 10 years (except under an              contract, or business arrangement. My recovery under this
Responsibilities Statement and any disclosure statement            extended or income-based repayment plan). The maximum             provision will not exceed the amount I paid on the loan.
I receive in connection with any loan under this MPN are           period for repaying a loan does not include periods of                Information about my loan(s) will be submitted to the
hereby incorporated into this MPN. If the information in           deferment or forbearance.                                         National Student Loan Data System (NSLDS). Information
this MPN conflicts with information in the disclosure, the             The lender will provide me with a repayment schedule          in NSLDS is accessible to schools, lenders, and guarantors
specific terms and information in the disclosure apply to          that identifies my payment amounts and due dates. Except          for specific purposes as authorized by the Department.
my loan.                                                           as otherwise provided in the Act, the minimum annual                  If I reside in the state in which the principal office
    I may request additional loan funds for my or the              payment required on all my FFELP loans is $600 or the             of the guarantor is located, the guarantor may sue to
student’s educational costs. The school will determine             amount of interest due and payable, whichever is larger.          enforce the applicable loan(s) in the county in which the
my eligibility and notify the lender. I will be notified of any    Payments submitted by me or on my behalf (exclusive               guarantor’s office is located. However, if I object to being
increase or other change in the amount of my loan(s).              of refunds) may be applied first to charges and collection        sued there and I mail a written objection to the guarantor
    I agree that the lender may sell or assign this MPN            costs that are due, then to accrued interest that has not         that is postmarked no later than 30 days after I am served
and/or my loan(s) and acknowledge that any loan may                been capitalized, and finally to the principal amount,            with the suit, the guarantor will either have the court
be assigned independently of any other loan to which               except during periods of repayment under an income-               transfer the suit to the county in which I live or will
this MPN applies. I agree that each loan is separately             based repayment plan, when payments will be applied               dismiss the lawsuit.
enforceable based on a true and exact copy of this MPN.            first to interest due, then to fees due, and then to the              Any notice required to be given to me will be effective
I understand that my lender may use a servicer to handle           principal amount.                                                 if sent by first class mail to the latest address the lender
billing and other communications related to my loan.                  If I am unable to make my scheduled loan payments,             has for me or by electronic means to an address that I have
                                                                   the lender may allow me to reduce my payment amount,              provided. I will immediately notify the lender of any change
loan Cancellation                                                  to extend the time for making payments, or to temporarily         of address or status as specified in the Borrower’s Rights
    I may pay back all or a part of a disbursement within          stop making payments as long as I intend to repay my              and Responsibilities Statement. Failure by the lender to
time frames set by the Act and explained in the Borrower’s         loan(s). Allowing me to temporarily delay or reduce loan          enforce or insist on compliance with any term of this MPN
Rights and Responsibilities Statement or other disclosure          payments is called forbearance. The lender may align              will not be a waiver of any right of the lender. No provision
I receive at or before disbursement. In such case, any             payment due dates on my loans or grant me a forbearance           of this MPN may be modified or waived except in writing.
origination fee and federal default fee will be reduced or         to eliminate a delinquency that persists even though I am         If any provision of this MPN is determined to be
eliminated in proportion to the amount of the disbursement         making scheduled payments.                                        unenforceable, the remaining provisions remain in force.
returned. I will not incur interest charges if I return the full      I may prepay all or any part of the unpaid balance on
loan amount as provided in the Act.                                my loan(s) at any time without penalty. If I do not specify
                                                                   which loan(s) I am prepaying, the lender will determine
Interest                                                           how to apply the prepayment in accordance with the Act.              Notice about Subsequent loans
    Unless my lender notifies me in writing of a lower             Upon payment in full of each loan under this MPN, I agree            Made under this MPN
rate(s), the rate(s) of interest for my loan(s) is that            to accept written notification of such loan payoff in place             This MPN authorizes the lender to disburse multiple
specified in the Act. Interest rate information is presented       of receiving the original MPN.                                       loans to pay my or the student’s educational costs
in the Borrower’s Rights and Responsibilities Statement                                                                                 during the multi-year term of this MPN. Such loans will
accompanying this MPN. The interest rate for each loan is          Acceleration and default                                             be made only upon my request and upon the school’s
presented in a disclosure that is issued to me.                        At the option of the lender, the entire unpaid balance           certification of my loan eligibility. Subsequent loans
    Interest accrues on the unpaid principal balance of each       of a loan made under this MPN will become immediately                for me or on behalf of the student named on this MPN
loan from the date of disbursement by the lender until the         due and payable if any one of the following events occurs            may be made for the same or subsequent periods of
entire principal balance is paid in full. This includes interest   regarding that loan: (i) I (or the student) do not enroll as at      enrollment at schools designated by the Secretary of
accruing during any period of deferment or forbearance.            least a half-time student at the school that certified my loan       the U.S. Department of Education.
I agree to pay all interest charges on my loan(s).                 eligibility, (ii) I do not use the proceeds of the loan solely
                                                                   for my or the student’s educational costs, (iii) I make a                I understand that no subsequent loan(s) will be
    I will begin paying interest upon disbursement of              false representation that results in my receiving a loan for         made under this MPN after the earliest of the following
my loan. If I do not make required payments of interest            which I am not eligible, or (iv) I default on the loan.              dates: (i) the date my lender receives my written notice
before the beginning or resumption of principal repayment,                                                                              that no further loans may be disbursed under the MPN;
or during a period of authorized deferment or forbearance,             The following events will constitute a default on a loan:
                                                                                                                                        (ii) one year after the date of my signature on this
I agree that the lender may capitalize such interest to the        (i) I do not pay the entire unpaid balance of the applicable
                                                                   loan after the lender has exercised its option under items           MPN if no disbursement is made during such twelve-
extent permitted by the Act.                                                                                                            month period; or (iii) ten years after either the date
                                                                   (i), (ii), or (iii) in the preceding paragraph; (ii) I do not
                                                                   make installment payments when due, provided my failure              of my signature on this MPN, or the date the lender
origination Fee and Federal default Fee                                                                                                 receives this MPN.
                                                                   has persisted for at least 270 days for payments due
   An origination fee is charged and a federal default fee         monthly or 330 days for payments due less frequently                    Any change to the Act applies to loans in accordance
may be charged for each loan made under this MPN.                  than monthly; or (iii) I do not comply with other terms              with the effective date of the change.
The Act specifies the maximum amount of each fee and               of the loan, and the lender or guarantor reasonably
  Federal Family Education Loan Program (FFELP)                                            Guarantor, Program, or Lender Identification


  Federal PLUS Loan Application and Master
  Promissory Note (MPN) Instructions and Notices

This is an MPN under which you may receive multiple Federal PLUS Loans for either yourself or for the same dependent student over a maximum 10-year period.
A Federal PLUS Loan is available to graduate or professional students or parents of dependent undergraduate students (“dependent” is defined in the Act and
is different from the definition used by the Internal Revenue Service) attending participating postsecondary schools. In this MPN, if you are the parent of a
dependent undergraduate student, all references to “student” mean the student identified in the Student Information Section. You are responsible for paying the
principal amount of your loan(s) and all interest that accrues from the date of disbursement until the loan(s) is paid in full.
Your lender will perform a credit check with a national consumer reporting agency before approving each loan. As required under federal law, if your lender
determines you have an adverse credit history, you may not borrow a Federal PLUS Loan unless: 1) you provide information to your lender’s satisfaction that there
are extenuating circumstances related to the adverse credit, or 2) you obtain an endorser who does not have an adverse credit history. An endorser is someone
who agrees to repay the loan if you fail to do so. The endorser may not be the student on whose behalf the loan is being made.

This form is to be completed by the graduate or            Item 8: Indicate your U.S. citizenship status. Contact      and who have known you for at least three years.
professional student borrower or the parent borrower.      the school’s financial aid office if you are unsure of      References with addresses outside the U.S. are not
Print using a dark ink ballpoint pen or type. Do not       your eligibility.                                           acceptable. If you are a parent borrower, do not list
complete this form in pencil. If an item has been            Item a: Check this box if you are a U.S. citizen or       the student as a reference. If a reference does not
completed for you and it is incorrect, cross out the         U.S. national. A U.S. citizen includes citizens of the    have a telephone number or e-mail address or does
incorrect information and print the correct information.     50 states, the District of Columbia, Puerto Rico, the     not wish to provide an e-mail address, enter N/A.
Enter dates as month-day-year (mm-dd-yyyy). Use              U.S. Virgin Islands, Guam, and the Northern Mariana       If you provide an e-mail address for a reference,
only numbers. Example: June 24, 1982 = 06-24-1982.           Islands. A U.S. national includes all U.S. citizens and   the lender or holder of your loan(s) may use it to
Incorrect, incomplete, or illegible information may          citizens of American Samoa and Swain’s Island.            communicate with the reference. All items must
cause your loan to be delayed.                                                                                         be completed or your loan will be delayed.
                                                             Item b: Check this box if you are a permanent
 Borrower Section                                            resident/other eligible non-citizen. Write in your         Student Information Section
                                                             eight- or nine-digit Alien Registration Number.
Check the appropriate box to indicate whether you                                                                      Complete this section only if you are a parent
                                                             “Permanent Resident” means someone who can
are a graduate or professional student borrower or                                                                     borrowing for a dependent undergraduate student.
                                                             provide documentation of this status from the U.S.
a parent borrower before completing the Borrower             Citizenship and Immigration Services (USCIS).             Item 14: Enter the student’s last name, first name,
Section.                                                     “Other Eligible Non-Citizen” includes individuals         and middle initial.
Item 1: Enter or correct your last name, first name,         who can provide documentation from the USCIS              Item 15: Enter the student’s Social Security Number.
and middle initial.                                          that they are in the U.S. for a purpose that is not
                                                                                                                       Item 16: Enter the date of the student’s birth. Be
Item 2: Enter or correct your Social Security Number.        temporary, with the intention of becoming a citizen
                                                                                                                       careful not to enter the current year.
Your loan(s) cannot be processed without a Social            or permanent resident. This category includes
Security Number. Read the Privacy Act and Financial          refugees, persons granted asylum, Cuban-Haitian
                                                                                                                        Borrower Request, Certifications, and Authorizations
Privacy Act Notices in these instructions before             entrants, temporary residents under the Immigration
                                                                                                                       Item 17: Each time you request Federal PLUS Loan
completing this item.                                        Reform and Control Act of 1986, and others.
                                                                                                                       funds, the school will notify you of the amount of
Item 3: Enter your permanent address (number,                NOTE: If your citizenship status is not one of the        funds you are eligible to borrow. You may decline a
street, apartment number) or rural route number              categories described above, you are not eligible          loan or request a lower amount by contacting your
and box number, then city, state, and zip code. If           to receive a Federal PLUS Loan.                           lender or the school. You should apply only for what
your mailing address is a post office box or general       Item 9: Enter the name and address of the lender            you will need to pay your or the student’s educational
delivery, you must list both your mailing address and      from which you wish to borrow. If you do not have           costs each year. Additional information is included
your street address or your rural route number and         a lender, contact the school’s financial aid office, a      under “Loan Cancellation” in the Borrower’s Rights
box number. If you do not have a permanent street          bank or other financial institution, or the guarantor       and Responsibilities Statement.
address or rural route number and box number,              or program listed on this form for information on           Items 18 and 19: Read these items carefully.
provide the physical location of your residence. A         lenders willing to make Federal PLUS Loans.
temporary school address is not acceptable.                Item 10: Enter the lender code, if known. Otherwise,         Promise to Pay
Item 4: Enter the area code and telephone number           leave this item blank.                                      Item 20: Read the entire MPN carefully. Then
at which you can most easily be reached. (Do not           Item 11: It is important that the lender is able to reach   complete Items 21 and 22.
list your work telephone number here.) If you do not       you during the process of making your loan and              Item 21: Sign your legal name, including your first
have a telephone, enter N/A.                               during repayment. Enter your employer’s name and            name, middle initial, and last name.
Item 5: Enter the date of your birth. Be careful not to    address (including number, street, suite number, city,      Item 22: Enter the date you are signing this MPN.
enter the current year.                                    state, and zip code). If you are self-employed, enter
Item 6: Enter your preferred e-mail address for            the name and address of your business. If you are
receiving communications. You are not required to          not employed, enter N/A.
provide this information. If you do, the lender or         Item 12: Enter your work telephone number (or the
holder of your loan(s) may use your e-mail address         number of your work cellular telephone or other
to communicate with you. If you do not have an             wireless device). If you are self-employed, enter the
e-mail address or do not wish to provide it,               telephone number of your business (or the number
enter N/A.                                                 of your business cellular telephone or other wireless
Item 7: Enter the two-letter abbreviation for the state    device). If you are not employed, enter N/A.
that issued your driver’s license followed by the          Item 13: Enter reference information for two adults
driver’s license number. If you do not have a driver’s     with different addresses who do not live with you
license, enter N/A.
Important Notices

Privacy Act Notice                                           student financial aid program regulations, or to locate     Financial Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that        you if you become delinquent in your loan payments          Under the Right to Financial Privacy Act of 1978 (12
the following notice be provided to you:                     or if you default. To provide default rate calculations,    U.S.C. 3401-3421), the U.S. Department of Education
                                                             disclosures may be made to guaranty agencies, to            will have access to financial records in your student
The authority for collecting the requested information       financial and educational institutions, or to state
from and about you is §421 et seq. of the Higher                                                                         loan file maintained by the lender in compliance with
                                                             agencies. To provide financial aid history information,     the administration of the Federal Family Education
Education Act (HEA) of 1965, as amended (20 U.S.C.           disclosures may be made to educational institutions.
1071 et seq.), and the authorities for collecting                                                                        Loan Program.
                                                             To assist program administrators with tracking
and using your Social Security Number (SSN) are              refunds and cancellations, disclosures may be made
§§428B(f) and 484(a)(4) of the HEA (20 U.S.C.                to guaranty agencies, to financial and educational          Paperwork Reduction Notice
1078-2(f) and 1091(a)(4)) and 31 U.S.C. 7701(b).             institutions, or to federal or state agencies. To provide
Participating in the Federal Family Education Loan                                                                       According to the Paperwork Reduction Act of 1995,
                                                             a standardized method for educational institutions          no persons are required to respond to a collection of
Program (FFELP) and giving us your SSN are                   to efficiently submit student enrollment status,
voluntary, but you must provide the requested                                                                            information unless it displays a currently valid OMB
                                                             disclosures may be made to guaranty agencies or             control number. The valid OMB control number for
information, including your SSN, to participate.             to financial and educational institutions. To counsel       this information collection is 1845-0069. The time
The principal purposes for collecting the information        you in repayment efforts, disclosures may be made           required to complete this information is estimated
on this form, including your SSN, are to verify your         to guaranty agencies, to financial and educational          to average 1.0 hours (60 minutes) per response,
identity, to determine your eligibility to receive a         institutions, or to federal, state, or local agencies.      including the time to review instructions, search
loan or a benefit on a loan (such as a deferment,            In the event of litigation, we may send records to          existing data resources, gather and maintain the data
forbearance, discharge, or forgiveness) under the            the Department of Justice, a court, adjudicative            needed, and complete and review the information
FFELP, to permit the servicing of your loan(s), and,         body, counsel, party, or witness if the disclosure          collection. If you have any comments concerning the
if it becomes necessary, to locate you and to collect        is relevant and necessary to the litigation. If this        accuracy of the time estimate(s) or suggestions for
and report on your loan(s) if your loan(s) becomes           information, either alone or with other information,        improving this form, please write to:
delinquent or in default. We also use your SSN as an         indicates a potential violation of law, we may send
account identifier and to permit you to access your                                                                      U.S. Department of Education
                                                             it to the appropriate authority for action. We may          Washington, DC 20202-4537
account information electronically.                          send information to members of Congress if you ask
The information in your file may be disclosed, on a          them to help you with federal student aid questions.        If you have any comments or concerns regarding
case-by-case basis or under a computer matching              In circumstances involving employment complaints,           the status of your individual submission of this form,
program, to third parties as authorized under routine        grievances, or disciplinary actions, we may disclose        contact the lender, guarantor, or program identified
uses in the appropriate systems of records notices.          relevant records to adjudicate or investigate the           in the upper right-hand corner of this form.
The routine uses of this information include, but are        issues. If provided for by a collective bargaining
not limited to, its disclosure to federal, state, or local   agreement, we may disclose records to a labor
agencies, to private parties such as relatives, present      organization recognized under 5 U.S.C. Chapter 71.
and former employers, business and personal                  Disclosures may be made to our contractors for the
associates, to consumer reporting agencies, to               purpose of performing any programmatic function
financial and educational institutions, and to guaranty      that requires disclosure of records. Before making
agencies in order to verify your identity, to determine      any such disclosure, we will require the contractor
your eligibility to receive a loan or a benefit on a loan,   to maintain Privacy Act safeguards. Disclosures may
to permit the servicing or collection of your loan(s),       also be made to qualified researchers under Privacy
to enforce the terms of the loan(s), to investigate          Act safeguards.
possible fraud and to verify compliance with federal
Borrower’s Rights and Responsibilities Statement
Important Notice: The Borrower's Rights and Responsibilities Statement provides additional information about the terms and conditions of loans you receive under the
Federal PLUS Loan Application and Master Promissory Note (MPN). Please keep a copy of this statement because it applies to present and subsequent loans received
under the MPN. You may contact your lender at any time for another copy of this statement.

The Federal Family Education Loan Program (FFELP)        multiple students), or individual check. If my loan        loan holder for information about the documentation
includes the following loans:                            money is disbursed by individual check, the check          I must provide to show that I qualify.
n Subsidized Federal Stafford Loan (formerly             will be copayable to me and the school and sent to
                                                         the school.                                                10. Payment of Interest — I am responsible for
   known as Guaranteed Student Loan [GSL]),                                                                         payment of all interest that accrues on the unpaid
n Unsubsidized Federal Stafford Loan,                    Generally, my loan money will be disbursed in              principal amount of my loan(s) from the date of
n Federal Insured Student Loan (FISL),                   multiple installments based on the academic terms          disbursement until the loan(s) is paid in full.
n Federal Supplemental Loans for Students (SLS),         at the school. If the school does not have academic
   also known as ALAS,                                   terms or does not have academic terms that meet            Under certain circumstances (for example, during
n Federal PLUS Loan,                                     certain requirements, my loan money will generally         deferment) I will not be required to make principal
n Federal Consolidation Loan.                            be disbursed in at least two installments, one at the      payments, but interest on my Federal PLUS Loan(s)
                                                         beginning and one at the midpoint of the enrollment        will accrue. I may pay this interest as it accrues (for
The FFELP is authorized by Title IV, Part B of the       period for the applicable loan.                            example, during an in-school deferment), or it may
Higher Education Act of 1965, as amended.                                                                           be capitalized (added to the principal of my loan(s)).
                                                         If my loan money exceeds the amount owed to the            If I inform my lender that I wish to pay interest as it
1. Governing Law — Loans disbursed under this            school, the school will forward the remainder of my        accrues, but I do not submit the payments, my lender
MPN are subject to the Higher Education Act of           loan money to me. If I am a parent borrower, I may         may capitalize that interest. If I inform my lender that
1965, as amended (20 U.S.C. 1070 et seq.) and            authorize the school to forward the remainder to           I do not wish to pay interest as it accrues, my lender
applicable U.S. Department of Education regulations      the student.                                               may capitalize that interest.
(collectively referred to as the “Act”). NOTE: Any
change to the Act applies to loans in accordance         If I (or the student) am enrolled in a foreign school,     Capitalized interest increases the principal balance
with the effective date of the change.                   the loan money will be disbursed directly to the           of my loan(s) and the total amount of interest I
                                                         foreign school by a check made copayable to me and         must pay.
2. Use of This MPN — I may receive more than one         the foreign school.
loan under this MPN over a period not to exceed                                                                     Interest on my loan(s) may be capitalized to the
10 years. If I am a graduate or professional student,    If I am a graduate or professional student and I have      extent permitted by the Act. Generally, capitalization
I may receive loans under this MPN for myself. If I      not previously received a Federal PLUS Loan or Direct      may occur no more frequently than quarterly.
am a parent, I may receive loans for the dependent       PLUS Loan, I must receive entrance counseling              (See the chart entitled, “Capitalization of Federal
student identified on the MPN. I may receive loans       before the school delivers the first disbursement of       PLUS Loan Interest,” for further information on
under this MPN from the original lender or from a        my Federal PLUS Loan.                                      capitalization.) The charts entitled, "Repaying Your
lender who assumes the right to offer loans under                                                                   Loans" allow me to estimate the cost of capitalization
this MPN, even if I (or the student) change schools      7. Change of Status — I must notify my lender or           and the effect it will have on my monthly payments.
and even if the guarantor changes. I may request in      any subsequent holder of my loan(s) if any of the          If my loan amount is not shown on the charts, I
writing that no further loans be disbursed under my      following occurs:                                          understand I must add two or more amounts together
MPN. If I wish to use a new lender, I must sign a new    n I change my address, telephone number,                   to estimate more closely my monthly interest and my
MPN. I must also sign a new MPN before receiving a          or e-mail address,                                      monthly payment.
new loan, if requested to do so by my lender.            n I change my name (for example, maiden name
                                                            to married name),                                       I may be able to claim a federal income tax deduction
3. Maximum Program Loan Amounts — I may                                                                             for interest payments I make on my FFELP loans. For
borrow amounts under this MPN not to exceed the          n I (or the student) fail to enroll at least half time
                                                            for the loan period at the school that certified my     further information, I may refer to the IRS Publication
cost of attendance minus any financial aid that has                                                                 970, available at http://www.irs.gov.
been or will be awarded for the period of enrollment.       eligibility for a PLUS Loan,
The school determines the cost of attendance based       n I (or the student) withdraw from school or begin         11. Loan Cancellation — I understand that the terms
on federal guidelines.                                      attending less than half time,                          of a full or partial loan cancellation depend on when
                                                         n I (or the student) transfer to another school,           I request the cancellation.
4. Use of Loan Money — I must use the loan money         n I (or the student) graduate, or the expected
for authorized educational costs incurred by me or, if      graduation date changes,                                n At any time before my loan money is disbursed,
I am a parent borrower, by the student for attendance    n I change my employer or my employer’s address              I may decline all or part of my loan money by
at the school that certified my eligibility for the         or telephone number changes, or                           notifying my lender or the school. No origination
time period shown on my disclosure statement.            n I have any other change in status that would               fee, federal default fee, or interest will be charged
Authorized costs include the following:                     affect my loan status (for example, the loss of           on the loan amount that is declined.
                                                            eligibility for an unemployment deferment by
n Tuition,                                                  obtaining a job).                                       n If the school receives the money by EFT or master
n Room,                                                                                                               check and has obtained my written confirmation
n Board,                                                 8. Effect of Federal Loans on Other Student Aid —            of the types and amounts of federal student loans
n School fees,                                           Receipt of a Federal PLUS Loan may affect eligibility        that I want to receive before crediting the loan
n Books,                                                 for other financial aid. Therefore, it may be beneficial     funds to my or the student's account, I may cancel
n Supplies,                                              to contact the school to determine eligibility for           all or a part of that loan by informing the school
n Equipment,                                             grants, work-study funds, subsidized loans, and              within 14 days after the date the school notifies
n Dependent child care,                                  other forms of student assistance before applying for        me of my right to cancel the loan, or by the first
n Transportation,                                        a Federal PLUS Loan(s). A graduate or professional           day of the school’s payment period, whichever is
n Commuting costs,                                       student must complete a Free Application for Federal         later. (The school can tell me the first day of the
n Rental or purchase of a personal computer,             Student Aid (FAFSA) and the school must determine            payment period.) If my school has not obtained my
n Origination fee and federal default fee, and/or        the student's eligibility for the maximum annual             written confirmation of the loans I want to receive,
n Other documented, authorized costs.                    amount of a Federal Stafford Loan (subsidized and            I may cancel all or part of the loan by informing the
                                                         unsubsidized) before the student applies for a Federal       school within 30 days of the date the school notifies
5. Loan Fees — I may be charged an origination fee       PLUS Loan.
and/or a federal default fee for each loan made under                                                                 me of my right to cancel the loan. If I cancel all or
this MPN. Neither fee may exceed the rate specified                                                                   a portion of a loan as described in this paragraph,
                                                         9. Interest Rates — The interest rate on a Federal           the school will return the cancelled amount to
in the Act. If I am charged these fees, they will be     PLUS Loan is a fixed rate of 8.5 percent. If I qualify
deducted proportionately from each disbursement.                                                                      my lender, and the loan fees will be eliminated or
                                                         under the Servicemembers Civil Relief Act, the               reduced in proportion to the amount returned.
                                                         interest rate on my loans obtained prior to military
6. Disbursement of Loan Money — My loan money            service may be limited to 6% during my military
will be disbursed to the school by electronic funds                                                                 n At any time within 120 days of disbursement,
                                                         service. To receive this benefit, I must contact my          I may pay back all or a part of that loan. The loan
transfer (EFT), master check (one check covering
  fees will be reduced or eliminated in proportion              payments, payments must be at least $50 a month            Except as provided by the Act for payments made
  to the amount returned.                                       and will be more if necessary to repay the loan(s)         under the income-based repayment plan, all
                                                                within the required time period. I am only eligible        payments and prepayments may be applied in
12. Repayment — All of my loans made under this                 for this plan if (i) at the time I obtain a loan under     the following order: late charges, fees, and collection
MPN must be repaid.                                             this MPN I have no outstanding balance on a                costs first, outstanding accrued interest second,
                                                                FFELP loan made before October 7, 1998, and (ii)           and outstanding principal last.
The repayment period for each loan made under this              I accumulate outstanding FFELP loans exceeding
MPN begins on the date of the final disbursement for            $30,000.                                                   If I fail to make any part of an installment payment
that loan. This means that each loan I receive under                                                                       within 15 days after it becomes due, I may owe a
this MPN will start repayment on a different date.            n Income-Sensitive Repayment Plan — If I choose              late charge. This charge may not exceed six cents
Unless I receive a deferment or forbearance, the first          this plan, my monthly payments will be adjusted            for each dollar of each late installment.
payment on each loan will be due within 60 days of              annually, based on my expected total monthly
the final disbursement of that loan. My lender will             gross income from all sources. I may contact my            13. Sale or Transfer of Loan(s) — The lender
notify me of the date my first payment is due. My               lender at any time for more information about this         may sell or otherwise transfer one or all of my
repayment schedule may include all of my FFELP                  repayment plan option.                                     loans without my consent. If ownership of a loan
loans that are owned by the lender.                                                                                        is transferred and the entity to which I must make
                                                              n Income-Based Repayment Plan (effective July                payments changes, I will be notified of that entity’s
I am obligated to make payments on my loan(s) even              1, 2009; for graduate and professional student             name, address and telephone number, the effective
if I do not receive a billing statement or repayment            PLUS borrowers only) — If I choose this plan, my           date of the sale or transfer, and the date when I
notice. My minimum annual payment required on all               required monthly payment amount will be based              must begin sending payments to that entity. Sale or
my FFELP loans will not, unless the lender otherwise            on my income during any period when I have a               transfer of my loan(s) does not affect my rights and
agrees, be less than $600, except during a portion              partial financial hardship. My monthly payment             responsibilities under such loan(s). If the lender sells
of the repayment period as provided in a graduated              amount may be adjusted annually. The maximum               my loan(s) to another originating lender, the lender
or income-sensitive repayment plan, in an extended              repayment period under this plan may exceed                may also transfer the right to offer subsequent loans
repayment plan with graduated payments, or in an                10 years. If I choose this plan and meet certain           under the MPN to such purchaser. I always have the
income-based repayment plan. Notwithstanding the                requirements over a 25-year period, I may qualify          right to terminate a lender’s ability to make loans to
preceding sentence, my minimum annual scheduled                 for cancellation of any outstanding balance on my          me under this MPN by written notice to the lender.
payments will not be less than the amount of interest           loans. I may contact my lender at any time for
due and payable, except as provided under an                    more information about this repayment plan.                14. Loan Discharge — My loan(s) will be discharged
income-based repayment plan.                                                                                               if acceptable documentation of my death or the
                                                              If I am a graduate or professional student, these            death of the student for whom I acquired a loan is
My repayment period for each loan generally lasts             repayment plans will be explained in more detail             submitted to my lender.
at least 5 years but may not exceed 10 years (except          during my exit counseling session.
under an extended or income-based repayment plan).                                                                         My loan(s) may also be discharged if I become totally
The maximum period for repaying a loan does not               Under each plan, the number or amount of payments            and permanently disabled as defined by the Act and
include periods of deferment or forbearance.                  may need to be adjusted to reflect capitalized interest      meet certain other requirements.
                                                              and/or new loans made to me.
I will be given the opportunity to choose one of                                                                           My loan(s) will not automatically be discharged
the following repayment plans:                                If I do not choose an income-sensitive, income-              in bankruptcy. In order to discharge a loan(s) in
                                                              based, graduated, or extended repayment plan within          bankruptcy, I must prove undue hardship in an
n Standard Repayment Plan — If I choose this plan,            45 days after notification of my repayment choices,          adversary proceeding before the bankruptcy court.
  I will make fixed monthly payments and repay my             or if I choose an income-sensitive repayment plan but
  loan(s) in full within 10 years from the date the           do not provide the required documentation within the         In certain cases, the Act provides for loan discharge
  loan(s) entered repayment. Payments must be at              lender-specified time frame, my lender will require          if I (or the student) could not complete a course of
  least $50 a month and will be more if necessary to          that I repay the loan(s) under a standard repayment          study because the school closed, if my loan eligibility
  repay the loan(s) within the required time period.          plan. If I choose an income-based repayment plan but         was falsely certified by the school, or if a loan in
                                                              do not provide the required documentation within the         my name was falsely certified as a result of a crime
n Graduated Repayment Plan — If I choose this                 time frame specified by the lender, I will be required       of identity theft. The Act also provides for loan
  plan, I will usually make lower monthly payments            to repay the loan(s) under a schedule provided by the        discharge in the amount of any required refund that
  at first, and my payments will increase over time.          lender in accordance with the Act. I may change the          the school did not make to my loan holder on
  No single payment will be more than three times             repayment plan on my loan(s) once a year, except             my behalf.
  greater than any other payment.                             that I may end an income-based repayment plan at
                                                              any time to repay under the standard repayment plan.         Neither the lender, the guarantor, nor the Department
n Extended Repayment Plan — If I choose this                                                                               of Education vouches for the quality or suitability
  plan, I will make monthly payments based on fixed           There will be no penalty for prepaying any portion           of the academic programs offered by participating
  annual or graduated repayment amounts over                  of my loan(s).                                               schools. Unless I qualify for loan discharge under the
  a period not to exceed 25 years. If I make fixed                                                                         Act, I must repay the loan(s) even if I (or the student)
 Capitalization of Federal PLUS Loan Interest

What is Capitalization?                                       This chart compares the monthly payments on a loan(s) where interest is paid while the loan is in a deferment
Capitalization is a process whereby a lender adds             or forbearance status and a loan(s) where the interest is capitalized. This example uses an interest rate of
unpaid interest to the principal balance of a loan(s).        8.5% and represents the loan amount outstanding when the borrower first enters repayment. This is an
I am responsible for paying the interest due on               estimate only. The actual interest capitalized will depend on factors such as disbursement date, number of
my Federal PLUS Loan(s) from the date the lender              disbursements, and the frequency of capitalization. The estimate of interest capitalized in these examples is
disburses the loan funds until the loan(s) is paid in full.   based on quarterly capitalization over a 12-month period.

If I am granted a deferment or forbearance and I              Treatment               Loan          Capitalized          Principal     Monthly       Number           Total
choose to defer and capitalize interest charges, the          of Interest             Amount        Interest for         to Be         Payment       of               Amount
principal balance of my loan(s) will increase each                                                   12 Months           Repaid                      Payments         Repaid
time my lender capitalizes unpaid interest. As a
                                                              When you pay            $15,000             $0             $15,000         $186             120         $23,593*
result, I will pay more interest charges over the life of     the interest
the loan(s). When I resume repaying my loan(s), my
monthly payment amount may be higher or, if                   When you don’t pay      $15,000           $1,316           $16,316         $202             120          $24,276
my loan(s) is subject to the $50 minimum payment,             the interest
I may be required to make more payments.                      *Total amount repaid includes $1,275 of interest paid by the borrower during the 12-month period of
                                                              deferment or forbearance.
I should contact my lender if I have any questions            Results: During repayment, you may pay $16 less per month and $683 less over the lifetime of your loan(s)
or need more information.                                     when you pay the interest as it is charged.
do not complete the education paid for with the          October 1, 2008) into the Direct Loan Program to          enrolled at least half time, my lender will process
loan(s), am unable to obtain employment in the field     take advantage of the no accrual of interest benefit      the deferment based on (i) my request along with
of study for which the school provided training, or      for active duty service members. No interest will be      documentation verifying my eligibility, or (ii) the
am dissatisfied with, or do not receive, the education   charged on the portion of my Direct Consolidation         lender’s receipt of a school certification of eligibility
paid for with the loan(s).                               Loan that repaid FFELP or Direct Loan Program loans       in connection with a new loan, or (iii) the lender’s
                                                         first disbursed on or after October 1, 2008 during        receipt of student status information indicating
For additional information, I should contact my          periods of qualifying active duty military service (for   that I am enrolled on at least a half-time basis. If my
lender or guarantor.                                     up to 60 months).                                         lender processes a deferment based on (ii) or (iii),
                                                                                                                   I will be notified of the deferment and will have the
15. Consequences of Default — Default is defined         The Act may provide for certain loan forgiveness or       option of canceling the deferment and continuing to
in detail in my MPN. If I default, the entire unpaid     repayment benefits on my loans in addition to the         make payments on my loan(s).
balance and collection fees on the applicable loan(s)    benefits described in this MPN. If other forgiveness
will become immediately due and payable. Failure         or repayment options become available, my loan            For all other deferments, I must provide my lender
to repay any loan made under this MPN may result         holder will provide information about these benefits.     with a deferment request (or, for a deferment
in any or all of the following:                                                                                    based on active duty or qualifying National Guard
n Loss of federal and state income tax refunds,          Under certain circumstances, military personnel           duty during a war or other military operation or
n Loss of other federal or state payments,               may have their federal education loan(s) repaid by the    national emergency, a representative may request
n Legal action against me,                               Secretary of Defense. I should address any questions      the deferment on my behalf). I must also provide
n Collection charges (including attorney fees)           to the local service recruiter. This is a recruiting      information and documentation that establishes my
   being assessed against me,                            program and does not pertain to prior service             eligibility, except in certain circumstances when my
n Loss of my professional license,                       individuals or those not eligible for enlistment in the   lender may establish my eligibility by confirming I
n An increase in my interest rate,                       Armed Forces.                                             have received a deferment on another FFELP loan or
n Loss of eligibility for other student aid and                                                                    on a Direct Loan.
                                                         Other agencies of the federal government may
   assistance under most federal benefit programs,       also offer student loan repayment programs as an
n Loss of eligibility for loan deferments,                                                                         NOTE: If at the time I obtain a loan under this MPN
                                                         incentive to recruit and retain employees. I should       I have an outstanding balance on a FFELP loan
n Negative credit reports to consumer reporting          contact the agency's human resources department
   agencies,                                                                                                       disbursed before July 1, 1993, information on
                                                         for more information.                                     deferment conditions that apply will be found in my
n Assignment of my loan to the Department, and/or
n My employer withholding part of my wages to                                                                      earlier promissory note materials.
                                                         18. Deferments — Under certain circumstances, I have
   give them to my guarantor or the Department           a right to defer (postpone) repayment. The types of       19. Forbearance — If I am unable to make any
   (administrative wage garnishment).                    deferments that are available to me generally depend      scheduled loan payment(s), the lender may allow me
                                                         on when I first obtained a FFELP loan. Upon request,      to reduce my payment amount, to extend the time
16. Consumer Reporting Agency Notification —             my lender will provide me with a deferment application
Information concerning the amount, disbursement,                                                                   for making payments, or to temporarily stop making
                                                         that explains the eligibility requirements. If I am in    payments as long as I intend to repay my loan(s).
and repayment status (current or delinquent) of          default on a loan, I am not eligible for a deferment on
my loan(s) will be reported by my lender to one                                                                    Allowing me to temporarily delay or reduce loan
                                                         that loan.                                                payments is called a forbearance. Interest continues
or more national consumer reporting agencies on
a regular basis. My loan(s) will be identified as an                                                               to accrue during a forbearance period.
                                                         Deferment of repayment for loans made under this
education loan(s). If I default on any loan(s) made      MPN is available:                                         The lender may grant me a forbearance due to poor
under this MPN, the default will also be reported                                                                  health or other acceptable reasons.
by the guarantor to all national consumer reporting      n While I am enrolled at least half time at an eligible
agencies. Before any guarantor reports such a              school,
                                                         n During the 6-month period after I cease to be           My lender is generally not required to grant a
default, it will give me at least 30 days notice that                                                              forbearance and may require me to provide my
default information will be disclosed to the consumer      enrolled at least half time,
                                                         n While the student for whom I obtained a loan is         reasons for the request and other information.
reporting agencies unless I enter into a repayment
arrangement within 30 days of the date on the              enrolled at least half time at an eligible school,      The lender may grant me a forbearance to eliminate
notice. The guarantor will give me a chance to ask       n During the 6-month period after the student for         a delinquency that persists even though I am making
for a review of the debt(s) before the default is          whom I obtained a loan ceases to be enrolled at         scheduled installment payments. My lender may grant
reported. My lender or guarantor, as applicable, must      least half time,                                        me an administrative forbearance for up to 60 days in
provide a timely response to a request from any          n While I am engaged in a full-time course of study       order to collect and process documentation supporting
consumer reporting agency regarding objections I           in a graduate fellowship program,                       my request for a deferment, forbearance, change in
might raise with that agency about the accuracy and      n While I am engaged in a full-time rehabilitation        repayment plan, consolidation, or discharge.
completeness of information reported by the lender         training program for individuals with disabilities
or guarantor.                                              (if the program is approved by the Department           Circumstances that require my lender to grant
                                                           of Education),                                          me a forbearance, if I provide appropriate
17. Special Repayment Arrangements —                     n While I am conscientiously seeking, but unable to       documentation, include:
A Federal Consolidation Loan Program is available          find, full-time employment (for up to three years),
                                                         n While I am experiencing an economic hardship as         n Serving in a medical or dental internship or
under which I may consolidate federal education                                                                       residency program, if I meet certain criteria.
loans received from different lenders, the same            determined by federal law (for up to three years),
                                                         n While I am serving on active duty during a war          n Serving in a national service position for which
lender, and/or under different federal education loan                                                                 I receive a national service education award
programs into one loan. Depending on the amount I          or other military operation or national emergency
                                                           or performing qualifying National Guard duty               under the National and Community Service Trust
borrow, this program may result in an extension                                                                       Act of 1993. In some cases, the interest that
of my repayment period. Consolidation permits              during a war or other military operation or national
                                                           emergency and, if I was serving on or after                accrues on a qualified loan during the service
multiple debts to be combined into one monthly                                                                        period will be paid by the Corporation for National
payment. For additional information, I should contact      October 1, 2007, for an additional 180-day period
                                                           following the demobilization date for my qualifying        and Community Service.
my lender or guarantor.                                                                                            n Qualifying for partial repayment of my loans
                                                           service, or
I may consolidate my FFELP loans into the Direct         n If I am a member of the National Guard or other            under the Student Loan Repayment Program, as
Loan Program to take advantage of the public service       reserve component of the U.S. Armed Forces                 administered by the Department of Defense.
loan forgiveness program. This program provides            (current or retired) and I am called or ordered to      n Having a monthly debt burden for Title IV loans
for the cancellation of the remaining balance due on       active duty while I am enrolled at least half time         that collectively equals or exceeds 20% of my total
eligible Direct Loan Program loans after I have made       at an eligible school or within 6 months of having         monthly gross income (for up to three years).
120 payments (after October 1, 2007) on those loans        been enrolled at least half time, during the 13         n Being called to active duty in the U.S. Armed
under certain repayment plans while employed in            months following the conclusion of my active duty          Forces.
certain public service jobs.                               service, or until I return to enrolled student status   For additional information, I should contact
                                                           on at least a half-time basis, whichever is earlier.    my lender.
I may also consolidate my FFELP loans first
disbursed on or after October 1, 2008 (including         For in-school deferments based on my enrollment
Federal Consolidation Loans that repaid FFELP or         status and (if I am a graduate or professional
Direct Loan Program loans first disbursed on or after    student) for the 6-month period after I cease to be
                                                                                                                                          Repayment information follows
 Repaying Your Loans

Follow these steps to estimate your loan payment.



  Step 1: Calculate Your Monthly Interest Charges                            Approximate Monthly Interest

  Round your Federal PLUS Loan balance up to the nearest                          Loan               8.5%
  $500. If your loan amount is not on the table, follow the
  example below to estimate your monthly accrued interest.                        Amount

  Example:                                                                        $     500      $    3.54
  Federal PLUS Loan of $5,479 at 8.5% interest.
                                                                                  $ 1,000        $    7.08
  Round up to nearest $500 = $5,500.
                                                                                  $ 3,000        $ 21.25
         $5,000 = $35.42/month                                                    $ 5,000        $ 35.42
         + 500 = $ 3.54/month                                                     $ 6,000        $ 42.50
         $5,500 = $38.96/month*                                                   $ 7,000        $ 49.58
                                                                                  $ 9,000        $ 63.75
  Your monthly interest $ ____________.
                                                                                  $ 10,000       $ 70.83
                                                                                  $ 15,000       $ 106.25
                                                                                  $ 20,000       $ 141.67
                                                                                  $ 25,000       $ 177.08




  Step 2: Estimate Your Capitalized Interest
                                                                              Monthly Interest                 Number of Months in                Estimate of
  Complete this step only if you will capitalize                              (From Step One)                Deferment or Forbearance         Capitalized Interest
  interest on a Federal PLUS Loan. This is an
  estimate only. Actual interest capitalized will          Example            $       38.96            X               22               =     $      857.12
  depend on factors such as disbursement dates,
  number of disbursements, and the frequency of            Your capitalized
  capitalization.                                          interest         $ ___________              X        ______________          =     $ ______________




  Step 3: Estimate Your Monthly Payment                                      Estimated Monthly Payments
                                                                                  (10-Year Term)
  Round your loan balance up to the nearest $500. If your
  principal amount is not on the table, follow the example below                   Loan              8.5%
  to estimate your monthly payment. If you previously had
                                                                                  Amount
  interest capitalized, add it to the outstanding loan amount to
  get the new principal amount.
                                                                                  $      500*    $    6.20
  Example:
  Federal PLUS Loan of $6,357.12 ($5,500.00 + $857.12)                            $ 1,000*       $ 12.40
  at 8.5% interest.                                                               $ 3,000*       $ 37.20
  Round up to nearest $500 = $6,500.                                              $ 5,000        $ 61.99
                                                                                  $ 6,000        $ 74.39
         $6,000 = $74.39/month
         + 500 = $ 6.20/month                                                     $ 7,000        $ 86.79
                                                                                  $ 9,000        $ 111.59
         $6,500 = $80.59/month
                                                                                  $ 10,000       $ 123.99
                                                                                  $ 15,000       $ 185.98
  Estimated monthly payment = $80.59                                              $ 20,000       $ 247.97
  *Minimum monthly payment = $50 or amount of interest                            $ 25,000       $ 309.96
  accruing each month.




                                      Loan                          Estimate of Capitalized                      New Principal                 Estimated
                                     Amount                        Interest (From Step Two)                        Balance                   Monthly Payment

    Example                     $ ___________
                                     5,500            +            $ ______________
                                                                         857.12                  =            $ ______________
                                                                                                                   6,357.12                       80.59
                                                                                                                                            $ ______________

    Your Monthly Payment        $ ___________         +            $ ______________              =            $ ______________              $ ______________
                                                                                                                      Guarantor, Program, or Lender Identification
Federal Family Education Loan Program (FFELP)                                                                                                                                                        OMB No. 1845-0069
                                                                                                                                                                                                     Form approved
                                                                                                                                                                                                     Exp. date 08/31/2010
Endorser Addendum to Federal PLUS Loan
Application and Master Promissory Note (MPN)
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any
accompanying document is subject to penalties that may include fines, imprisonment, or both, under the
U.S. Criminal Code and 20 U.S.C. 1097.

Notice to Endorser
This is an addendum to the MPN signed by the borrower of the Federal PLUS Loan. The borrower may be either a graduate or professional student or the parent of a dependent
undergraduate student. If the borrower is the parent of a dependent undergraduate student, references to "student" in this addendum mean the dependent undergraduate student
identified in Section B., Item 16. By signing this addendum, you are agreeing to repay only the loan that is identified in Section B of this addendum, if the borrower does not repay
the loan. No additional loans may be made to the borrower under this MPN. The Endorser Addendum contains the terms and conditions of the MPN signed by the borrower and
the Borrower’s Rights and Responsibilities Statement (Endorser’s Copy). As an endorser, you are not entitled to all of the same benefits as a Federal PLUS Loan borrower. For
complete information regarding your rights and responsibilities as an endorser, please read the Borrower’s Rights and Responsibilities Statement (Endorser’s Copy).
Section A. Endorser Section                                                                                                                   Print using a dark ink ballpoint pen or type. Read the instructions carefully.
1. Last Name                                                              First Name                                                         MI                     2. Social Security Number


3. Permanent Address (See instructions.)                                                                                                                            4. Area Code/Telephone Number
                                                                                                                                                                        (         )

   City                                                                   State                    Zip Code                                                         5. Date of Birth (mm-dd-yyyy)



6. E-mail Address                                                                                                    7. Driver’s License State and Number
                                                                                                                         State           #

8. U.S. Citizenship Status (Check a or b, and if b is checked, list Registration Number.)
    r     a. Citizen/National          r    b. Permanent Resident /Other Eligible Non-Citizen            If “b,” Alien Registration Number

9. Employer Name, Address, City, State, Zip Code                                                                                                                   10. Work Area Code/Telephone Number
                                                                                                                                                                    (         )
11. Endorser References: You must provide two separate references with different U.S. addresses who do not live with you and who have known you for at least three years. Do not list either the PLUS Loan
                         borrower or the student as a reference.
     Name                                   A.                                                                                               B.

     Permanent Address

     City, State, Zip Code

     E-mail Address

     Area Code/Telephone Number                  (            )                                                                                   (          )

     Relationship to Endorser

Section B. Loan Description                                                                                                                                      To be completed by the lender, endorser, and/or borrower.
12. Borrower Name (last, first, MI)                                                                                                                          13. Borrower Social Security Number



14. Requested PLUS Loan Amount                                                                                                                               15. Date Borrower Signed MPN (mm-dd-yyyy)



16. Student Name (last, first, MI)                                                                                                                           17. Student Social Security Number


18. Name and Address of School



Section C. Endorser Certifications and Authorizations
I authorize the lender, the guarantor, or their agents to investigate my credit record and report information concerning my credit to persons and organizations permitted by law to receive such
information.
I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to contact me regarding the loan for which I am serving as an endorser, including
repayment of the loan, at the current or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded voice
or text messages.
Under penalty of perjury, I certify that the information contained in the Endorser Section of this Addendum is true, complete, and correct. If I am the endorser for the parent of a dependent undergraduate
student, I further certify that I am not the student on whose behalf the parent borrower is requesting the Federal PLUS Loan.
Endorser Promise to Pay                                                                                                                                                               Read carefully before signing below.

In this addendum, “lender” refers to, and this addendum benefits, the original lender and its successors and assigns, including any subsequent holder of this addendum and MPN.
Although I will not personally receive any loan proceeds, I promise to pay to the order of the lender the full amount of the loan described above and disbursed under the MPN signed by the borrower,
plus interest and other charges and fees that may become due, if the borrower does not repay the loan upon demand by the lender. If this debt is ever in default, I will pay reasonable collection costs,
including, but not limited to, attorney fees, court costs, and other fees.
I understand that the lender can use the same collection methods against me that can be used against the borrower, such as suing me, garnishing my wages, etc. I understand that if this debt is ever in
default that fact will become part of my credit record.
I understand that this is an addendum to the MPN. I will not sign this addendum before reading it and the entire MPN, even if I am told not to read it, or told that I am not required to read it. I am
entitled to a copy of this addendum and a copy of the Federal PLUS Borrower’s Rights and Responsibilities Statement. My signature certifies I have read, understand, and agree to the terms and
conditions of this addendum, the MPN, and the Borrower’s Rights and Responsibilities Statement, as applicable.

I UNDERSTAND THIS IS A FEDERAL LOAN THAT I MUST REPAY IF THE BORROWER DOES NOT.


19. Endorser Signature                                                                                                 20. Today’s Date (mm-dd-yyyy)                              Additional Addendum provisions follow
Endorser Addendum to Federal PLUS Loan Application and Master Promissory Note (MPN) (continued)
Governing Law                                                  before the beginning or resumption of principal                due and payable if any one of the following events
   The terms of this MPN will be interpreted in                repayment, or during a period of authorized deferment or       occurs regarding that loan: (i) I (or the student) do not
accordance with the Higher Education Act of 1965, as           forbearance, I agree that the lender may capitalize such       enroll as at least a half-time student at the school that
amended (20 U.S.C. 1070 et seq.), the U.S. Department          interest to the extent permitted by the Act.                   certified my loan eligibility, (ii) I do not use the proceeds
of Education’s (the Department’s) regulations, as they                                                                        of the loan solely for my or the student’s educational
may be amended in accordance with their effective date,        Origination Fee and Federal Default Fee                        costs, (iii) I make a false representation that results in
and other applicable federal statutes and regulations             An origination fee is charged and a federal default         my receiving a loan for which I am not eligible, or (iv) I
(collectively referred to as the “Act”), and the guarantor’s   fee may be charged for each loan made under this               default on the loan.
policies. Applicable state law, except as preempted by         MPN. The Act specifies the maximum amount of each                  The following events will constitute a default on a
federal law, may provide for certain borrower rights,          fee and authorizes both fees to be deducted from my            loan: (i) I do not pay the entire unpaid balance of the
remedies, and defenses in addition to those stated in          loan amount. The fees I am charged, as identified in the       applicable loan after the lender has exercised its option
this MPN.                                                      disclosure statement, will be deducted proportionately         under items (i), (ii), or (iii) in the preceding paragraph;
                                                               from each disbursement of my loan(s). I understand the         (ii) I do not make installment payments when due,
Disclosure of Terms                                            origination and federal default fees may be refundable         provided my failure has persisted for at least 270 days
   Loans disbursed under this MPN are subject to the           only to the extent permitted by the Act.                       for payments due monthly or 330 days for payments due
loan limits specified in the Act. Under this MPN, the                                                                         less frequently than monthly; or (iii) I do not comply
principal amount that I owe and am required to repay,          Late Charges and Collection Costs                              with other terms of the loan, and the lender or guarantor
will be the sum of all disbursements issued (unless I             The lender may collect from me: (i) a late charge for       reasonably concludes I no longer intend to honor my
reduce or cancel any disbursements as provided below).         each late installment payment if I do not make any part        repayment obligation. If I default, the guarantor may
                                                               of a required installment payment within 15 days after         purchase my loan(s) and capitalize all outstanding
   My lender will determine whether to make any loan                                                                          interest into a new principal balance. The new principal
under this MPN after my eligibility is determined by the       the date it becomes due, and (ii) any other charges and
                                                               fees that are permitted by the Act for the collection of       balance and collection fees will become immediately due
school. At or before the time of the first disbursement                                                                       and payable.
for each loan, a disclosure statement will be provided         my loan(s). If I default on any loan(s), I will pay
to me identifying the amount of the loan and additional        reasonable collection fees and costs, plus court costs            If I default, the default will be reported to all national
terms of the loan. Important additional information            and attorney fees.                                             consumer reporting agencies and will significantly and
is also disclosed in the Borrower’s Rights and                                                                                adversely affect my credit history. I understand that
Responsibilities Statement accompanying this MPN. The          Repayment                                                      a default will have additional adverse consequences
Borrower’s Rights and Responsibilities Statement and              I must repay the full amount of the loan(s) made            to me as disclosed in the Borrower’s Rights and
any disclosure statement I receive in connection with          under this MPN and accrued interest. I will repay the          Responsibilities Statement. Following default, the loan(s)
any loan under this MPN are hereby incorporated into           principal of each loan in periodic installments during         may be subject to income-based or income-contingent
this MPN. If the information in this MPN conflicts with        a repayment period that begins on the day of the final         repayment (including potential collection of amounts in
information in the disclosure, the specific terms and          disbursement for that loan.                                    excess of the principal and interest) in accordance with
information in the disclosure apply to my loan.                                                                               the Act.
                                                                  My lender must provide me with a choice of
   I may request additional loan funds for my or the           repayment plans consistent with the provisions of the          Legal Notices
student’s educational costs. The school will determine         Act. My repayment period for each loan generally lasts at
my eligibility and notify the lender. I will be notified       least 5 years but may not exceed 10 years (except under           Any lender holding a loan made under this MPN is
of any increase or other change in the amount of my            an extended or income-based repayment plan). The               subject to all claims and defenses that I could assert
loan(s).                                                       maximum period for repaying a loan does not include            against the school with respect to that loan if (i) the
                                                               periods of deferment or forbearance.                           loan was made by the school or a school-affiliated
    I agree that the lender may sell or assign this MPN                                                                       organization, (ii) the lender who made the loan provided
and/or my loan(s) and acknowledge that any loan may                The lender will provide me with a repayment schedule       an improper inducement (as defined by the Act) to the
be assigned independently of any other loan to which           that identifies my payment amounts and due dates.              school or to any other party in connection with the
this MPN applies. I agree that each loan is separately         Except as otherwise provided in the Act, the minimum           making of the loan, (iii) the school refers loan applicants
enforceable based on a true and exact copy of this MPN.        annual payment required on all my FFELP loans is $600          to the lender, or (iv) the school is affiliated with the
I understand that my lender may use a servicer to handle       or the amount of interest due and payable, whichever           lender by common control, contract, or business
billing and other communications related to my loan.           is larger. Payments submitted by me or on my behalf            arrangement. My recovery under this provision will not
                                                               (exclusive of refunds) may be applied first to charges         exceed the amount I paid on the loan.
Loan Cancellation                                              and collection costs that are due, then to accrued
                                                               interest that has not been capitalized, and finally to the        Information about my loan(s) will be submitted
   I may pay back all or a part of a disbursement                                                                             to the National Student Loan Data System (NSLDS).
within time frames set by the Act and explained in the         principal amount, except during periods of repayment
                                                               under an income-based repayment plan, when payments            Information in NSLDS is accessible to schools, lenders,
Borrower’s Rights and Responsibilities Statement or                                                                           and guarantors for specific purposes as authorized by
other disclosure I receive at or before disbursement. In       will be applied first to interest due, then to fees due, and
                                                               then to the principal amount.                                  the Department.
such case, any origination fee and federal default fee will
be reduced or eliminated in proportion to the amount              If I am unable to make my scheduled loan payments,             If I reside in the state in which the principal office
of the disbursement returned. I will not incur interest        the lender may allow me to reduce my payment amount,           of the guarantor is located, the guarantor may sue to
charges if I return the full loan amount as provided in        to extend the time for making payments, or to                  enforce the applicable loan(s) in the county in which the
the Act.                                                       temporarily stop making payments as long as I intend           guarantor’s office is located. However, if I object to being
                                                               to repay my loan(s). Allowing me to temporarily delay or       sued there and I mail a written objection to the guarantor
Interest                                                       reduce loan payments is called forbearance. The lender         that is postmarked no later than 30 days after I am
                                                               may align payment due dates on my loans or grant me a          served with the suit, the guarantor will either have the
   Unless my lender notifies me in writing of a lower                                                                         court transfer the suit to the county in which I live or will
rate(s), the rate(s) of interest for my loan(s) is that        forbearance to eliminate a delinquency that persists even
                                                               though I am making scheduled payments.                         dismiss the lawsuit.
specified in the Act. Interest rate information is
presented in the Borrower’s Rights and Responsibilities           I may prepay all or any part of the unpaid balance on           Any notice required to be given to me will be effective
Statement accompanying this MPN. The interest rate             my loan(s) at any time without penalty. If I do not specify    if sent by first class mail to the latest address the lender
for each loan is presented in a disclosure that is issued      which loan(s) I am prepaying, the lender will determine        has for me or by electronic means to an address that
to me.                                                         how to apply the prepayment in accordance with the             I have provided. I will immediately notify the lender
                                                               Act. Upon payment in full of each loan under this MPN, I       of any change of address or status as specified in the
   Interest accrues on the unpaid principal balance                                                                           Borrower’s Rights and Responsibilities Statement.
of each loan from the date of disbursement by the              agree to accept written notification of such loan payoff in
                                                               place of receiving the original MPN.                           Failure by the lender to enforce or insist on compliance
lender until the entire principal balance is paid in full.                                                                    with any term of this MPN will not be a waiver of any
This includes interest accruing during any period of                                                                          right of the lender. No provision of this MPN may be
deferment or forbearance. I agree to pay all interest          Acceleration and Default
                                                                                                                              modified or waived except in writing. If any provision
charges on my loan(s).                                            At the option of the lender, the entire unpaid balance
                                                                                                                              of this MPN is determined to be unenforceable, the
  I will begin paying interest upon disbursement of            of a loan made under this MPN will become immediately
                                                                                                                              remaining provisions remain in force.
my loan. If I do not make required payments of interest
 Federal Family Education Loan Program (FFELP)                                             Guarantor, Program, or Lender Identification


 Endorser Addendum to Federal PLUS Loan
 Application and Master Promissory Note (MPN)
 Instructions and Notices
 Section A. Endorser Section                                                                                                                     To be completed by the endorser.
The Federal PLUS Loan Program allows a graduate or          Item 1: Enter or correct your last name, first name, and            Item b: Check this box if you are a permanent
professional student or the parent(s) of a dependent        middle initial.                                                     resident/other eligible non-citizen. Write in your
undergraduate student to borrow a Federal PLUS                                                                                  eight- or nine-digit Alien Registration Number.
                                                            Item 2: Enter or correct your Social Security Number.
Loan. By completing an MPN, the borrower may obtain                                                                             "Permanent Resident" means someone who can
                                                            An application without the endorser’s Social Security
multiple PLUS Loans for himself/herself or for the same                                                                         provide documentation of this status from the U.S.
                                                            Number will not be processed. Read the Privacy Act
student over a maximum 10-year period.                                                                                          Citizenship and Immigration Services (USCIS).
                                                            and Financial Privacy Act Notices in these instructions
                                                                                                                                "Other Eligible Non-Citizen" includes individuals who
If the borrower is ineligible for a Federal PLUS Loan       before completing this item.
                                                                                                                                can provide documentation from the USCIS that they
because of an adverse credit history, the borrower          Item 3: Enter your permanent address (number, street,               are in the U.S. for a purpose that is not temporary,
must obtain an endorser to receive the loan, unless the     apartment number) or rural route number and box                     with the intention of becoming a citizen or permanent
borrower documents to the satisfaction of the lender        number, then city, state, and zip code. If your mailing             resident. This category includes refugees, persons
that extenuating circumstances exist. An endorser is        address is a post office box or general delivery, you must          granted asylum, Cuban-Haitian entrants, temporary
someone who agrees to repay the loan if the borrower        list both your mailing address and your street address or           residents under the Immigration Reform and Control
fails to do so. If the borrower is the parent of a          your rural route number and box number. If you do not               Act of 1986, and others.
dependent undergraduate student, the endorser may           have a permanent street address or rural route number               NOTE: If your citizenship status is not one of the
not be the student on whose behalf the loan is being        and box number, provide the physical location of your               categories described above, you are not eligible to
made. The endorser must be a U.S. citizen, permanent        residence.                                                          be an endorser.
resident or other eligible noncitizen, and must not
have an adverse credit history. If the borrower secures     Item 4: Enter the area code and telephone number at             Item 9: It is important that the lender is able to reach
an endorser for the Federal PLUS Loan, he or she is         which you can most easily be reached. (Do not list your         you during the process of making this loan and during
not eligible for the multi-loan feature of the MPN. In      work telephone number here.) If you do not have a               repayment. Enter your employer’s name and address
this case, the borrower must sign a new MPN and an          telephone, enter N/A.                                           (including number, street, suite number, city, state, and
endorser must sign a new Endorser Addendum for each         Item 5: Enter the date of your birth. Be careful not to         zip code). If you are self-employed, enter the name and
loan requested during the period in which the borrower      enter the current year.                                         address of your business. If you are not employed, enter
has an adverse credit history.                                                                                              N/A.
                                                            Item 6: Enter your preferred e-mail address for receiving
Lenders participating in the Federal PLUS Loan Program      communications. You are not required to provide this            Item 10: Enter your work telephone number (or the
may elect whether to make loans with endorsers. Check       information. If you do, the lender or holder of your            number of your work cellular telephone or other wireless
with the lender for information on its endorser policies.   loan(s) may use your e-mail address to communicate              device). If you are self-employed, enter the telephone
                                                            with you. If you do not have an e-mail address or do not        number of your business (or the number of your
If you are willing to serve as an endorser for the
                                                            wish to provide it, enter N/A.                                  business cellular telephone or other wireless device).
borrower identified in Section B, read, complete, and
                                                                                                                            If you are not employed, enter N/A.
return this form to the lender, guarantor, or program       Item 7: Enter the two-letter abbreviation for the
identified in the upper right hand corner of this form.     state that issued your driver’s license followed by             Item 11: Enter reference information for two adults with
If you have questions regarding this form, contact          the driver’s license number. If you do not have a driver’s      different addresses who do not live with you and who
the lender, guarantor, or program.                          license, enter N/A.                                             have known you for at least three years. References
                                                                                                                            with addresses outside the U.S. are not acceptable. Do
Print using a dark ink ballpoint pen or type. Do not        Item 8: Indicate your U.S. citizenship status.                  not list either the PLUS Loan borrower or the student
complete this form in pencil. If you are making several
                                                               Item a: Check this box if you are a U.S. citizen or          as a reference. If a reference does not have a telephone
copies, press firmly on a hard surface. If an item has
                                                               U.S. national. A U.S. citizen includes citizens of the       number or e-mail address or does not wish to provide
been completed for you and is incorrect, cross out the
                                                               50 states, the District of Columbia, Puerto Rico, the        an e-mail address, enter N/A. If you provide an e-mail
incorrect information and print the correct information.
                                                               U.S. Virgin Islands, Guam, and the Northern Mariana          address for a reference, the lender or holder of your
Enter dates as month-day-year (mm-dd-yyyy). Use
                                                               Islands. A U.S. national includes all U.S. citizens and      loan(s) may use it to communicate with the reference.
only numbers. Example: June 24, 1982 = 06-24-1982.
                                                               citizens of American Samoa and Swain’s Island.               All items must be completed or your loan will be delayed.
Incorrect, incomplete, or illegible information may cause
the loan to be delayed.

 Section B. Loan Description                                                                                             To be completed by the lender, endorser, and/or borrower.

This Endorser Addendum refers to the loan and               Item 12: Enter the borrower’s last name, first name, and        Item 15: Enter the date the borrower signed the MPN.
supporting MPN identified in this section.                  middle initial. The borrower may be either a graduate           Note: Complete Items 16 and 17 only if you are an
Note: Items 12-18 may be prefilled by the lender.           or professional student or the parent of a dependent            endorser for the parent of a dependent undergraduate
Be sure to review this information for accuracy and         undergraduate student.                                          student.
completeness. If you do not agree to endorse the full       Item 13: Enter the borrower’s Social Security Number.           Item 16: Enter the dependent undergraduate student’s
amount the borrower requested, reduce the amount
                                                            Item 14: Enter the maximum amount of Federal PLUS               last name, first name, and middle initial.
in Item 14, and initial the change. Go to Item 19 and
                                                            Loan the borrower requested.                                    Item 17: Enter the student’s Social Security Number.
finish completing the form.
                                                            The borrower’s requested loan amount is the maximum             Item 18: Enter the name and city/state of the school the
                                                            loan amount that can be approved unless the amount the          student will attend (or is attending).
                                                            endorser agrees to is less than the borrower’s request.
 Endorser Promise to Pay                                                                                                                         To be completed by the endorser.

Item 19: Sign your legal name, including your first         By signing, you:                                                b) Agree to repay the loan in full according to the terms
name, middle initial, and last name.                                                                                           and conditions of this Addendum if the borrower
                                                            a) Acknowledge that you have read, understand,
Item 20: Enter the date you are signing this Addendum.                                                                         does not.
                                                               and agree to the provisions in the Endorser
                                                               Addendum, and
 Important Notices

Privacy Act Notice                                           student financial aid program regulations, or to locate     Financial Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that        you if you become delinquent in your loan payments          Under the Right to Financial Privacy Act of 1978 (12
the following notice be provided to you:                     or if you default. To provide default rate calculations,    U.S.C. 3401-3421), the U.S. Department of Education
                                                             disclosures may be made to guaranty agencies, to            will have access to financial records in your student
The authority for collecting the requested information       financial and educational institutions, or to state
from and about you is §421 et seq. of the Higher                                                                         loan file maintained by the lender in compliance with
                                                             agencies. To provide financial aid history information,     the administration of the Federal Family Education
Education Act (HEA) of 1965, as amended (20 U.S.C.           disclosures may be made to educational institutions.
1071 et seq.) and the authorities for collecting                                                                         Loan Program.
                                                             To assist program administrators with tracking
and using your Social Security Number (SSN) are              refunds and cancellations, disclosures may be made
§§428B(f) and 484(a)(4) of the HEA (20 U.S.C.                to guaranty agencies, to financial and educational          Paperwork Reduction Notice
1078-2(f) and 1091(a)(4)) and 31 U.S.C. 7701(b).             institutions, or to federal or state agencies. To provide
Participating in the Federal Family Education Loan                                                                       According to the Paperwork Reduction Act of 1995,
                                                             a standardized method for educational institutions          no persons are required to respond to a collection of
Program (FFELP) and giving us your SSN are                   to efficiently submit student enrollment status,
voluntary, but you must provide the requested                                                                            information unless it displays a currently valid OMB
                                                             disclosures may be made to guaranty agencies or             control number. The valid OMB control number for
information, including your SSN, to participate.             to financial and educational institutions. To counsel       this information collection is 1845-0069. The time
The principal purposes for collecting the information        you in repayment efforts, disclosures may be made           required to complete this information is estimated
on this form, including your SSN, are to verify your         to guaranty agencies, to financial and educational          to average 1.0 hours (60 minutes) per response,
identity, to determine your eligibility to receive a         institutions, or to federal, state, or local agencies.      including the time to review instructions, search
loan or a benefit on a loan (such as a deferment,            In the event of litigation, we may send records to          existing data resources, gather and maintain the data
forbearance, discharge, or forgiveness) under the            the Department of Justice, a court, adjudicative            needed, and complete and review the information
FFELP, to permit the servicing of your loan(s), and,         body, counsel, party, or witness if the disclosure          collection. If you have any comments concerning the
if it becomes necessary, to locate you and to collect        is relevant and necessary to the litigation. If this        accuracy of the time estimate(s) or suggestions for
and report on your loan(s) if your loan(s) becomes           information, either alone or with other information,        improving this form, please write to:
delinquent or in default. We also use your SSN as an         indicates a potential violation of law, we may send
account identifier and to permit you to access your                                                                      U.S. Department of Education
                                                             it to the appropriate authority for action. We may          Washington, DC 20202-4537
account information electronically.                          send information to members of Congress if you ask
The information in your file may be disclosed, on a          them to help you with federal student aid questions.        If you have any comments or concerns regarding
case-by-case basis or under a computer matching              In circumstances involving employment complaints,           the status of your individual submission of this form,
program, to third parties as authorized under routine        grievances, or disciplinary actions, we may disclose        contact the lender, guarantor, or program identified
uses in the appropriate systems of records notices.          relevant records to adjudicate or investigate the           in the upper right-hand corner of this form.
The routine uses of this information include, but are        issues. If provided for by a collective bargaining
not limited to, its disclosure to federal, state, or local   agreement, we may disclose records to a labor
agencies, to private parties such as relatives, present      organization recognized under 5 U.S.C. Chapter 71.
and former employers, business and personal                  Disclosures may be made to our contractors for the
associates, to consumer reporting agencies, to               purpose of performing any programmatic function
financial and educational institutions, and to guaranty      that requires disclosure of records. Before making
agencies in order to verify your identity, to determine      any such disclosure, we will require the contractor
your eligibility to receive a loan or a benefit on a loan,   to maintain Privacy Act safeguards. Disclosures may
to permit the servicing or collection of your loan(s),       also be made to qualified researchers under Privacy
to enforce the terms of the loan(s), to investigate          Act safeguards.
possible fraud and to verify compliance with federal
Borrower’s Rights and Responsibilities Statement (Endorser's Copy)
Important Notice: The Borrower’s Rights and Responsibilities Statement (Endorser’s Copy) provides additional information about the terms and conditions of the loan the
borrower receives under the Federal PLUS Loan Application and Master Promissory Note (MPN). Please keep a copy of this statement. You may contact your lender at any time for
another copy of this statement.

  Note to Endorser: If you are the endorser of a               the Act. If I am charged these fees, they will be deducted       6% during my military service. To receive this benefit, I
  Federal PLUS Loan, you are not entitled to all of the        proportionately from each disbursement.                          must contact my loan holder for information about the
  same benefits as a Federal PLUS Loan borrower,                                                                                documentation I must provide to show that I qualify.
  and not all of the terms and conditions of a Federal         6. Disbursement of Loan Money — My loan money
  PLUS Loan apply to you. However, you should read             will be disbursed to the school by electronic funds               Note to Endorser: You are not eligible for the
  the entire Borrower’s Rights and Responsibilities            transfer (EFT), master check (one check covering                  reduced interest rate described above unless you
  Statement. Important information that applies to you         multiple students), or individual check. If my loan money         qualify under the Servicemembers Civil Relief Act
  as an endorser has been highlighted.                         is disbursed by individual check, the check will be               based on your own military service.
                                                               copayable to me and the school and sent to the school.
The Federal Family Education Loan Program (FFELP)                                                                               10. Payment of Interest — I am responsible for
includes the following loans:                                  Generally, my loan money will be disbursed in multiple           payment of all interest that accrues on the unpaid
n Subsidized Federal Stafford Loan (formerly                   installments based on the academic terms at the school.          principal amount of my loan(s) from the date of
  known as Guaranteed Student Loan [GSL]),                     If the school does not have academic terms or does not           disbursement until the loan(s) is paid in full.
n Unsubsidized Federal Stafford Loan,                          have academic terms that meet certain requirements,
n Federal Insured Student Loan (FISL),                         my loan money will generally be disbursed in at least            Under certain circumstances (for example, during
n Federal Supplemental Loans for Students (SLS), also          two installments, one at the beginning and one at the            deferment) I will not be required to make principal
  known as ALAS,                                               midpoint of the enrollment period for the applicable loan.       payments, but interest on my Federal PLUS Loan(s) will
n Federal PLUS Loan,                                                                                                            accrue. I may pay this interest as it accrues (for example,
n Federal Consolidation Loan.                                  If my loan money exceeds the amount owed to the                  during an in-school deferment) or it may be capitalized
                                                               school, the school will forward the remainder of my loan         (added to the principal of my loan(s)). If I inform my
The FFELP is authorized by Title IV, Part B of the Higher      money to me. If I am a parent borrower, I may authorize          lender that I wish to pay interest as it accrues, but I do
Education Act of 1965, as amended.                             the school to forward the remainder to the student.              not submit the payments, my lender may capitalize that
                                                                                                                                interest. If I inform my lender that I do not wish
1. Governing Law — Loans disbursed under this                  If I (or the student) am enrolled in a foreign school,           to pay interest as it accrues, my lender may capitalize
MPN are subject to the Higher Education Act of 1965,           the loan money will be disbursed directly to the foreign         that interest.
as amended (20 U.S.C. 1070 et seq.) and applicable             school by a check made copayable to me and the
U.S. Department of Education regulations (collectively         foreign school.                                                  Capitalized interest increases the principal balance
referred to as the “Act”). NOTE: Any change to the Act                                                                          of my loan(s) and the total amount of interest I
                                                               If I am a graduate or professional student and I have            must pay.
applies to loans in accordance with the effective date
                                                               not previously received a Federal PLUS Loan or Direct
of the change.
                                                               PLUS Loan, I must receive entrance counseling before             Interest on my loan(s) may be capitalized to the extent
2. Use of This MPN — I may receive more than one loan          the school delivers the first disbursement of my Federal         permitted by the Act. Generally, capitalization may
under this MPN over a period not to exceed 10 years. If        PLUS Loan.                                                       occur no more frequently than quarterly. (See the chart
I am a graduate or professional student, I may receive                                                                          entitled, “Capitalization of Federal PLUS Loan Interest,”
                                                               7. Change of Status — I must notify my lender or                 for further information on capitalization.) The charts
loans under this MPN for myself. If I am a parent, I may
                                                               any subsequent holder of my loan(s) if any of the                entitled, "Repaying Your Loans" allow me to estimate
receive loans for the dependent student identified on
                                                               following occurs:                                                the cost of capitalization and the effect it will have on
the MPN. I may receive loans under this MPN from the
original lender or from a lender who assumes the right         n I change my address, telephone number, or                      my monthly payments. If my loan amount is not shown
to offer loans under this MPN, even if I (or the student)        e-mail address,                                                on the charts, I understand I must add two or more
change schools and even if the guarantor changes. I            n I change my name (for example, maiden name                     amounts together to estimate more closely my monthly
may request in writing that no further loans be disbursed        to married name),                                              interest and my monthly payment.
under my MPN. If I wish to use a new lender, I must sign       n I (or the student) fail to enroll at least half time for the
                                                                 loan period at the school that certified my eligibility        I may be able to claim a federal income tax deduction for
a new MPN. I must also sign a new MPN before receiving
                                                                 for a PLUS Loan,                                               interest payments I make on my FFELP loans. For further
a new loan, if requested to do so by my lender.
                                                               n I (or the student) withdraw from school or begin               information, I may refer to the IRS Publication 970,
3. Maximum Program Loan Amounts — I may borrow                   attending less than half time,                                 available at http://www.irs.gov.
amounts under this MPN not to exceed the cost of               n I (or the student) transfer to another school,                 11. Loan Cancellation — I understand that the terms
attendance minus any financial aid that has been or will       n I (or the student) graduate, or the expected graduation        of a full or partial loan cancellation depend on when I
be awarded for the period of enrollment. The school              date changes,                                                  request the cancellation.
determines the cost of attendance based on federal             n I change my employer or my employer’s address or
guidelines.                                                      telephone number changes, or                                   n At any time before my loan money is disbursed,
                                                               n I have any other change in status that would affect my           I may decline all or part of my loan money by
4. Use of Loan Money — I must use the loan money                 loan status (for example, the loss of eligibility for an         notifying my lender or the school. No origination fee,
for authorized educational costs incurred by me or, if I         unemployment deferment by obtaining a job).                      federal default fee, or interest will be charged on the
am a parent borrower, by the student for attendance at
                                                                                                                                  loan amount that is declined.
the school that certified my eligibility for the time period     Note to Endorser: You must notify the lender if you
shown on my disclosure statement. Authorized costs               change your address, telephone number, e-mail                  n If the school receives the money by EFT or master
include the following:                                           address, name, or employer, or if your employer’s                check and has obtained my written confirmation of
n   Tuition,                                                     address or telephone number changes.                             the types and amounts of federal student loans that
n   Room,                                                                                                                         I want to receive before crediting the loan funds to
                                                               8. Effect of Federal Loans on Other Student Aid —                  my or the student’s account, I may cancel all or a
n   Board,
                                                               Receipt of a Federal PLUS Loan may affect eligibility              part of that loan by informing the school within 14
n   School fees,
                                                               for other financial aid. Therefore, it may be beneficial           days after the date the school notifies me of my right
n   Books,
                                                               to contact the school to determine eligibility for grants,         to cancel the loan, or by the first day of the school’s
n   Supplies,
                                                               work-study funds, subsidized loans, and other forms                payment period, whichever is later. (The school can
n   Equipment,
                                                               of student assistance before applying for a Federal                tell me the first day of the payment period.) If my
n   Dependent child care,
                                                               PLUS Loan(s). A graduate or professional student must              school has not obtained my written confirmation of
n   Transportation,
                                                               complete a Free Application for Federal Student Aid                the loans I want to receive, I may cancel all or part
n   Commuting costs,
                                                               (FAFSA) and the school must determine the student’s                of the loan by informing the school within 30 days of
n   Rental or purchase of a personal computer,
                                                               eligibility for the maximum annual amount of a Federal             the date the school notifies me of my right to cancel
n   Origination fee and federal default fee, and/or
                                                               Stafford Loan (subsidized and unsubsidized) before the             the loan. If I cancel all or a portion of a loan as
n   Other documented, authorized costs.
                                                               student applies for a Federal PLUS Loan.                           described in this paragraph, the school will return the
5. Loan Fees — I may be charged an origination fee                                                                                cancelled amount to my lender, and the loan fees will
                                                               9. Interest Rates — The interest rate on a Federal PLUS
and/or a federal default fee for each loan made under                                                                             be eliminated or reduced in proportion to the amount
                                                               Loan is a fixed rate of 8.5 percent. If I qualify under the
this MPN. Neither fee may exceed the rate specified in                                                                            returned.
                                                               Servicemembers Civil Relief Act, the interest rate on my
                                                               loans obtained prior to military service may be limited to
n At any time within 120 days of disbursement, I may          necessary to repay the loan(s) within the required           Except as provided by the Act for payments made under
  pay back all or a part of that loan. The loan fees will     time period. I am only eligible for this plan if (i) at      the income-based repayment plan, all payments and
  be reduced or eliminated in proportion to the               the time I obtain a loan under this MPN I have no            prepayments may be applied in the following order: late
  amount returned.                                            outstanding balance on a FFELP loan made before              charges, fees, and collection costs first, outstanding
                                                              October 7, 1998, and (ii) I accumulate outstanding           accrued interest second, and outstanding principal last.
12. Repayment — All of my loans made under this MPN           FFELP loans exceeding $30,000.
must be repaid.                                                                                                            If I fail to make any part of an installment payment within
                                                            n Income-Sensitive Repayment Plan — If I choose                15 days after it becomes due, I may owe a late charge.
The repayment period for each loan made under this            this plan, my monthly payments will be adjusted              This charge may not exceed six cents for each dollar of
MPN begins on the date of the final disbursement for          annually, based on my expected total monthly                 each late installment.
that loan. This means that each loan I receive under this     gross income from all sources. I may contact my
MPN will start repayment on a different date. Unless I        lender at any time for more information about this           13. Sale or Transfer of Loan(s) — The lender may sell
qualify for a deferment or forbearance, my first payment      repayment plan option.                                       or otherwise transfer one or all of my loans without my
on each loan will be due within 60 days of the final                                                                       consent. If ownership of a loan is transferred and the
disbursement of that loan. My lender will notify me of      n Income-Based Repayment Plan (effective July                  entity to which I must make payments changes, I will
the date my first payment is due. My repayment                1, 2009; for graduate and professional student               be notified of that entity’s name, address and telephone
schedule may include all of my FFELP loans that are           PLUS borrowers only) — If I choose this plan, my             number, the effective date of the sale or transfer, and the
owned by the lender.                                          required monthly payment amount will be based on             date when I must begin sending payments to that entity.
                                                              my income during any period when I have a partial            Sale or transfer of my loan(s) does not affect my rights
I am obligated to make payments on my loan(s) even if         financial hardship. My monthly payment amount                and responsibilities under such loan(s). If the lender sells
I do not receive a billing statement or repayment notice.     may be adjusted annually. The maximum repayment              my loan(s) to another originating lender, the lender may
The minimum annual payment required on all my FFELP           period under this plan may exceed 10 years. If I             also transfer the right to offer subsequent loans under
loans will not, unless the lender otherwise agrees, be        choose this plan and meet certain requirements over          the MPN to such purchaser. I always have the right to
less than $600, except during a portion of the repayment      a 25-year period, I may qualify for cancellation of any      terminate a lender’s ability to make loans to me under
period as provided in a graduated or income-sensitive         outstanding balance on my loans. I may contact my            this MPN by written notice to the lender.
repayment plan, in an extended repayment plan with            lender at any time for more information about this
graduated payments, or in an income-based repayment           repayment plan.                                              14. Loan Discharge — My loan(s) will be discharged
plan. Notwithstanding the preceding sentence, my                                                                           if acceptable documentation of my death or the death of
minimum annual scheduled payments will not be less          If I am a graduate or professional student, these              the student for whom I acquired a loan is submitted to
than the amount of interest due and payable, except as      repayment plans will be explained in more detail during        my lender.
provided under an income-based repayment plan.              my exit counseling session.
                                                                                                                           My loan(s) may also be discharged if I become totally
My repayment period for each loan generally lasts at        Under each plan, the number or amount of payments              and permanently disabled as defined by the Act and meet
least 5 years but may not exceed 10 years (except under     may need to be adjusted to reflect capitalized interest        certain other requirements.
an extended or income-based repayment plan). The            and/or new loans made to me.
maximum period for repaying a loan does not include                                                                        My loan(s) will not automatically be discharged in
periods of deferment or forbearance.                        If I do not choose an income-sensitive, income-based,          bankruptcy. In order to discharge a loan(s) in bankruptcy,
                                                            graduated, or extended repayment plan within 45 days           I must prove undue hardship in an adversary proceeding
I will be given the opportunity to choose one of the        after notification of my repayment choices, or if I choose     before the bankruptcy court.
following repayment plans:                                  an income-sensitive repayment plan but do not provide
                                                            the required documentation within the lender-specified         In certain cases, the Act provides for loan discharge if
n Standard Repayment Plan — If I choose this plan,          time frame, my lender will require that I repay the            I (or the student) could not complete a course of study
  I will make fixed monthly payments and repay my           loan(s) under a standard repayment plan. If I choose an        because the school closed, if my loan eligibility was
  loan(s) in full within 10 years from the date the         income-based repayment plan but do not provide the             falsely certified by the school, or if a loan in my name
  loan(s) entered repayment. Payments must be at least      required documentation within the time frame specified         was falsely certified as a result of a crime of identity theft.
  $50 a month and will be more if necessary to repay        by the lender, I will be required to repay the loan(s)         The Act also provides for loan discharge in the amount of
  the loan(s) within the required time period.              under a schedule provided by the lender in accordance          any required refund that the school did not make to my
                                                            with the Act. I may change the repayment plan on my            loan holder on my behalf.
n Graduated Repayment Plan — If I choose this plan,         loan(s) once a year, except that I may end an income-
  I will usually make lower monthly payments at first,      based repayment plan at any time to repay under the            Neither the lender, the guarantor, nor the Department
  and my payments will increase over time. No single        standard repayment plan.                                       of Education vouches for the quality or suitability of the
  payment will be more than three times greater than                                                                       academic programs offered by participating schools.
  any other payment.                                         Note to Endorser: If you are making payments on the           Unless I qualify for loan discharge under the Act, I
                                                             borrower’s Federal PLUS Loan, you may request a               must repay the loan(s) even if I (or the student) do not
n Extended Repayment Plan — If I choose this plan,           change of repayment plans by contacting the lender.           complete the education paid for with the loan(s), am
  I will make monthly payments based on fixed annual                                                                       unable to obtain employment in the field of study for
  or graduated repayment amounts over a period not to       There will be no penalty for prepaying any portion             which the school provided training, or am dissatisfied
  exceed 25 years. If I make fixed payments, payments       of my loan(s).                                                 with, or do not receive, the education paid for with
  must be at least $50 a month and will be more if                                                                         the loan(s).

Capitalization of Federal PLUS Loan Interest
What is Capitalization?                                     This chart compares the monthly payments on a loan(s) where interest is paid while the loan is in a deferment
Capitalization is a process whereby a lender adds unpaid    or forbearance status and a loan(s) where the interest is capitalized. This example uses an interest rate of
interest to the principal balance of a loan(s). I am        8.5% and represents the loan amount outstanding when the borrower first enters repayment. This is an
responsible for paying the interest due on my Federal       estimate only. The actual interest capitalized will depend on factors such as disbursement date, number of
PLUS Loan(s) from the date the lender disburses the         disbursements, and the frequency of capitalization. The estimate of interest capitalized in these examples is
loan funds until the loan(s) is paid in full.               based on quarterly capitalization over a 12-month period.

If I am granted a deferment or forbearance and I            Treatment                 Loan           Capitalized         Principal       Monthly         Number            Total
choose to defer and capitalize interest charges, the        of Interest               Amount         Interest for        to Be           Payment         of                Amount
principal balance of my loan(s) will increase each                                                   12 Months           Repaid                          Payments          Repaid
time my lender capitalizes unpaid interest. As a
result, I will pay more interest charges over the life      When you pay              $15,000               $0           $15,000           $186              120           $23,593*
                                                            the interest
of the loan(s). When I resume repaying my loan(s),
my monthly payment amount may be higher or, if my           When you don’t pay        $15,000         $1,316          $16,316         $202           120           $24,276
loan(s) is subject to the $50 minimum payment, I            the interest
may be required to make more payments.                      *Total amount repaid includes $1,275 of interest paid by the borrower during the 12-month period of deferment
                                                            or forbearance.
I should contact my lender if I have any questions          Results: During repayment, you may pay $16 less per month and $683 less over the lifetime of your loan(s) when
                                                            you pay the interest as it is charged.
or need more information.
For additional information, I should contact my lender or         first disbursed on or after October 1, 2008) into the          half time, my lender will process the deferment based
guarantor.                                                        Direct Loan Program to take advantage of the no accrual        on (i) my request along with documentation verifying
                                                                  of interest benefit for active duty service members. No        my eligibility, or (ii) the lender’s receipt of a school
  Note to Endorser: If the full amount of the borrower’s          interest will be charged on the portion of my Direct           certification of eligibility in connection with a new loan,
  loan is discharged for any of the conditions                    Consolidation Loan that repaid FFELP or Direct Loan            or (iii) the lender’s receipt of student status information
  described above, you are no longer obligated to                 Program loans first disbursed on or after October 1,           indicating that I am enrolled on at least a half-time
  make any payments on the loan.                                  2008 during periods of qualifying active duty military         basis. If my lender processes a deferment based on (ii)
                                                                  service (for up to 60 months).                                 or (iii), I will be notified of the deferment and will have
15. Consequences of Default — Default is defined in                                                                              the option of canceling the deferment and continuing to
detail in my MPN. If I default, the entire unpaid balance           Note to Endorser: You are not eligible to apply for a
                                                                    Consolidation Loan to repay a PLUS Loan for which            make payments on my loan(s).
and collection fees on the applicable loan(s) will become
immediately due and payable. Failure to repay any loan              you are the endorser.                                        For all other deferments, I must provide my lender
made under this MPN may result in any or all of the                                                                              with a deferment request (or, for a deferment based on
following:                                                        The Act may provide for certain loan forgiveness or
                                                                  repayment benefits on my loans in addition to the              active duty or qualifying National Guard duty during a
n   Loss of federal and state income tax refunds,                 benefits described in this MPN. If other forgiveness or        war or other military operation or national emergency, a
n   Loss of other federal or state payments,                      repayment options become available, my loan holder will        representative may request the deferment on my behalf).
n   Legal action against me,                                      provide information about these benefits.                      I must also provide information and documentation that
n   Collection charges (including attorney fees)                                                                                 establishes my eligibility, except in certain circumstances
    being assessed against me,                                      Note to Endorser: You are not eligible for the loan          when my lender may establish my eligibility by
n   Loss of my professional license,                                forgiveness and repayment benefits described above.          confirming I have received a deferment on another
n   An increase in my interest rate,                                                                                             FFELP loan or on a Direct Loan.
n   Loss of eligibility for other student aid and                 Under certain circumstances, military personnel may
                                                                  have their federal education loan(s) repaid by the             NOTE: If at the time I obtain a loan under this MPN I
    assistance under most federal benefit programs,
                                                                  Secretary of Defense. I should address any questions to        have an outstanding balance on a FFELP loan disbursed
n   Loss of eligibility for loan deferments,
                                                                  the local service recruiter. This is a recruiting program      before July 1, 1993, information on deferment conditions
n   Negative credit reports to consumer reporting
                                                                  and does not pertain to prior service individuals or those     that apply will be found in my earlier promissory
    agencies,
                                                                  not eligible for enlistment in the Armed Forces.               note materials
n   Assignment of my loan to the Department, and/or
n   My employer withholding part of my wages to                                                                                    Note to Endorser: You are not eligible to receive
    give them to my guarantor or the Department                   Other agencies of the federal government may also
                                                                  offer student loan repayment programs as an incentive            a deferment.
    (administrative wage garnishment).
                                                                  to recruit and retain employees. I should contact
                                                                  the agency’s human resources department for more               19. Forbearance — If I am unable to make any
  Note to Endorser: If the borrower defaults on the                                                                              scheduled loan payment(s), the lender may allow me
  loan, and you do not make payments on the loan,                 information.
                                                                                                                                 to reduce my payment amount, to extend the time
  you may also be subject to the actions described                                                                               for making payments, or to temporarily stop making
  above.                                                          18. Deferments — Under certain circumstances, I have
                                                                  a right to defer (postpone) repayment. The types of            payments as long as I intend to repay my loan(s).
                                                                  deferments that are available to me generally depend on        Allowing me to temporarily delay or reduce loan
16. Consumer Reporting Agency Notification —
                                                                  when I first obtained a FFELP loan. Upon request, my           payments is called a forbearance. Interest continues to
Information concerning the amount, disbursement, and
                                                                  lender will provide me with a deferment application that       accrue during a forbearance period.
repayment status (current or delinquent) of my loan(s)
will be reported by my lender to one or more national             explains the eligibility requirements. If I am in default on
                                                                  a loan, I am not eligible for a deferment on that loan.        The lender may grant me a forbearance due to poor
consumer reporting agencies on a regular basis. My                                                                               health or other acceptable reasons.
loan(s) will be identified as an education loan(s). If I
default on any loan(s) made under this MPN, the default           Deferment of repayment for loans made under this MPN           My lender is generally not required to grant a forbearance
will also be reported by the guarantor to all national            is available:                                                  and may require me to provide my reasons for the request
consumer reporting agencies. Before any guarantor                 n While I am enrolled at least half time at an eligible        and other information.
reports such a default, it will give me at least 30 days notice     school,
that default information will be disclosed to the consumer        n During the 6-month period after I cease to be enrolled       The lender may grant me a forbearance to eliminate
reporting agencies unless I enter into a repayment                  at least half time,                                          a delinquency that persists even though I am making
arrangement within 30 days of the date on the notice.             n While the student for whom I obtained a loan is              scheduled installment payments. My lender may grant me
The guarantor will give me a chance to ask for a review             enrolled at least half time at an eligible school,           an administrative forbearance for up to 60 days in order to
of the debt(s) before the default is reported. My lender or       n During the 6-month period after the student for              collect and process documentation supporting my request
guarantor, as applicable, must provide a timely response            whom I obtained a loan ceases to be enrolled at least        for a deferment, forbearance, change in repayment plan,
to a request from any consumer reporting agency                     half time,                                                   consolidation, or discharge.
regarding objections I might raise with that agency about         n While I am engaged in a full-time course of study in a       Circumstances that require my lender to grant me a
the accuracy and completeness of information reported               graduate fellowship program,                                 forbearance, if I provide appropriate documentation,
by the lender or guarantor.                                       n While I am engaged in a full-time rehabilitation             include:
                                                                    training program for individuals with disabilities
  Note to Endorser: If the borrower of a Federal PLUS               (if the program is approved by the Department                n Serving in a medical or dental internship or residency
  Loan defaults on the loan, the lender may also                    of Education),                                                 program, if I meet certain criteria.
  report your name to consumer reporting agencies in              n While I am conscientiously seeking, but unable to            n Serving in a national service position for which I
  connection with the delinquent or defaulted loan.                 find, full-time employment (for up to three years),            receive a national service education award under the
                                                                  n While I am experiencing an economic hardship as                National and Community Service Trust Act of 1993.
17. Special Repayment Arrangements — A Federal                      determined by federal law (for up to three years),             In some cases, the interest that accrues on a qualified
Consolidation Loan Program is available under which               n While I am serving on active duty during a war or              loan during the service period will be paid by the
I may consolidate federal education loans received                  other military operation or national emergency or              Corporation for National and Community Service.
from different lenders, the same lender, and/or under               performing qualifying National Guard duty during a           n Qualifying for partial repayment of my loans under the
different federal education loan programs into one                  war or other military operation or national emergency          Student Loan Repayment Program, as administered
loan. Depending on the amount I borrow, this program                and, if I was serving on or after October 1, 2007,             by the Department of Defense.
may result in an extension of my repayment period.                  for an additional 180-day period following the               n Having a monthly debt burden for Title IV loans
Consolidation permits multiple debts to be combined                 demobilization date for my qualifying service, or              that collectively equals or exceeds 20% of my total
into one monthly payment. For additional information, I           n If I am a member of the National Guard or other                monthly gross income (for up to three years).
should contact my lender or guarantor.                              reserve component of the U.S. Armed Forces (current          n Being called to active duty in the U.S. Armed Forces.
I may consolidate my FFELP loans into the Direct Loan               or retired) and I am called or ordered to active duty
                                                                    while I am enrolled at least half time at an eligible        For additional information, I should contact my lender.
Program to take advantage of the public service loan
forgiveness program. This program provides for the                  school or within 6 months of having been enrolled at
                                                                    least half time, during the 13 months following the            Note to Endorser: Although you are not eligible to
cancellation of the remaining balance due on eligible                                                                              receive a deferment, you may receive a forbearance.
Direct Loan Program loans after I have made 120                     conclusion of my active duty service, or until I return
payments (after October 1, 2007) on those loans under               to enrolled student status on at least a half-time basis,
certain repayment plans while employed in certain public            whichever is earlier.
service jobs.                                                     For in-school deferments based on my enrollment status
I may also consolidate my FFELP loans first disbursed on          and (if I am a graduate or professional student) for
or after October 1, 2008 (including Federal Consolidation         the 6-month period after I cease to be enrolled at least
Loans that repaid FFELP or Direct Loan Program loans                                                                                               Repayment information follows
 Repaying Your Loans

Follow these steps to estimate your loan payment.



  Step 1: Calculate Your Monthly Interest Charges                    Approximate Monthly Interest

  Round your Federal PLUS Loan balance up to the nearest                 Loan                8.5%
  $500. If your loan amount is not on the table, follow the
  example below to estimate your monthly accrued interest.              Amount

  Example:                                                              $    500         $    3.54
  Federal PLUS Loan of $5,479 at 8.5% interest.
                                                                        $ 1,000          $    7.08
  Round up to nearest $500 = $5,500.
                                                                        $ 3,000          $ 21.25
         $5,000 = $35.42/month                                          $ 5,000          $ 35.42
         + 500 = $ 3.54/month                                           $ 6,000          $ 42.50
         $5,500 = $38.96/month*                                         $ 7,000          $ 49.58
                                                                        $ 9,000          $ 63.75
  Your monthly interest $ ____________.
                                                                        $ 10,000         $ 70.83
                                                                        $15,000          $ 106.25
                                                                        $ 20,000         $ 141.67
                                                                        $ 25,000         $ 177.08




  Step 2: Estimate Your Capitalized Interest
                                                                             Monthly Interest                 Number of Months in               Estimate of
  Complete this step only if you will capitalize                             (From Step One)                Deferment or Forbearance         Capitalized Interest
  interest on a Federal PLUS Loan. This is an
  estimate only. Actual interest capitalized will          Example           $      38.96               X             22               =     $      857.12
  depend on factors such as disbursement dates,
  number of disbursements, and the frequency               Your capitalized
  of capitalization.                                       interest         $ ___________               X      ______________          =     $ ______________




  Step 3: Estimate Your Monthly Payment                              Estimated Monthly Payments
                                                                            (10-Year Term)
  Round your loan balance up to the nearest $500. If your
  principal amount is not on the table, follow the example below         Loan                8.5%
  to estimate your monthly payment. If you previously had
                                                                        Amount
  interest capitalized, add it to the outstanding loan amount to
  get the new principal amount.
                                                                         $   500 *      $     6.20
  Example:
  Federal PLUS Loan of $6,357.12 ($5,500.00 + $857.12)                   $ 1,000 *      $ 12.40
  at 8.5% interest.                                                      $ 3,000 *      $ 37.20
  Round up to nearest $500 = $6,500.                                     $ 5,000        $ 61.99
                                                                         $ 6,000        $ 74.39
         $6,000 = $74.39/month
         + 500 = $ 6.20/month                                            $ 7,000        $ 86.79
                                                                         $ 9,000        $ 111.59
         $6,500 = $80.59/month
                                                                         $ 10,000       $ 123.99
                                                                         $ 15,000       $ 185.98
  Estimated monthly payment = $80.59
                                                                         $ 20,000        $247.97
  *Minimum monthly payment = $50 or amount of interest                   $ 25,000       $ 309.96
   accruing each month.




                                     Loan                      Estimate of Capitalized                         New Principal                  Estimated
                                    Amount                    Interest (From Step Two)                           Balance                    Monthly Payment

    Example                     $ ___________
                                     5,500            +            $ ______________
                                                                         857.12                     =        $ ______________
                                                                                                                  6,357.12                       80.59
                                                                                                                                           $ ______________

    Your Monthly Payment        $ ___________         +            $ ______________                 =        $ ______________              $ ______________
Federal Family Education Loan Program (FFELP)                                                            Guarantor, Program, or Lender Identification                              OMB No. 1845-0069
                                                                                                                                                                                   Form approved
                                                                                                                                                                                   Exp. date 08/31/2010
Federal PLUS Loan Information and
School Certification
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any
accompanying document is subject to penalties that may include fines, imprisonment, or both, under the
U.S. Criminal Code and 20 U.S.C. 1097.

 (Reserved for school, lender, or guarantor mailing address as appropriate)                              1. School Code


                                                                                                         2. School Information (Name, Address, and Phone Number)




Borrower and Student Information
 3. Borrower Last Name                                                                   First Name                       MI                                4. Borrower Social Security Number



 5. Permanent Address (See instructions.)                                                                 6. Area Code/Telephone Number                     7. Borrower Date of Birth (mm-dd-yyyy)



    City                                                     State                       Zip Code        8. Borrower E-mail Address



 9. Lender Name/Lender Code, if known                                                    City                             State



10. Borrower Requested Loan Amount                                                                       11. Loan Period (mm-dd-yyyy)
    $                          .00                                                                           From:                                             To:

12. Student Last Name                                     First Name                      MI             13. Student Social Security Number                14. Student Date of Birth (mm-dd-yyyy)



School Certification Information                                                                                                                                     (To be completed only by the school.)
15. Enrollment Status (Check one)                                                                        16. Anticipated Graduation (Completion) Date (mm-dd-yyyy)

     r     Full Time         r   At Least Half Time

17. Loan Period (mm-dd-yyyy)                                                                             18. Grade Level                                   19. Certified Loan Amount

    From:                                                 To:                                                                                                  $                             .00


20. Recommended Disbursement Date(s) (mm-dd-yyyy)

    1st                                  2nd                                   3rd                        4th                               5th                             6th

This space reserved for additional disbursement dates, if needed.




School Certification                                                                                                                                                 (To be completed only by the school.)
 I certify:
 • That the graduate or professional student borrower or the dependent undergraduate student named on this Certification is accepted for enrollment in an eligible program on at least a
   half-time basis; is a U.S. citizen, permanent resident, or other eligible non-citizen; and is making satisfactory academic progress;
 • That the borrower is an eligible borrower in accordance with the Higher Education Act of 1965, as amended, and applicable U.S. Department of Education regulations (collectively
   referred to as the Act) and has been determined eligible for a loan in the amount certified;
 • That the borrower, if a graduate or professional student, has completed a Free Application for Federal Student Aid (FAFSA) and that the borrower’s eligibility for the maximum annual
   amount of a Stafford Loan (subsidized and unsubsidized) has been determined;
 • That the disbursement schedule complies with the requirements of the Act;
 • Based on available records and appropriate inquiry, that:
   (i) the graduate or professional student borrower or the dependent undergraduate has met the requirements of the Selective Service Act, and is not incarcerated;
   (ii) neither the borrower nor, if applicable, the dependent undergraduate student is liable for an overpayment of any federal grant or loan made under the Act;
   (iii) neither the borrower nor, if applicable, the dependent undergraduate student is in default on any Title IV education loan(s); or if the borrower or student is in default, satisfactory
   repayment arrangements have been made with the holder(s) of any defaulted loan(s);
   (iv) neither the borrower nor, if applicable, the dependent undergraduate student has been convicted of or pled nolo contendere (no contest) or guilty to a crime involving fraud in
   obtaining funds under Title IV of the Act, as amended; or if the borrower or student has pled nolo contendere or guilty to such a crime, the borrower or student has repaid the funds to
   the Secretary of Education or to the loan holder in the case of a Title IV federal student loan;
   (v) neither the borrower nor, if applicable, the dependent undergraduate student has property subject to a judgment lien for a debt owed to the U.S.; and
   (vi) the information provided in this Certification is true, complete, and accurate to the best of my knowledge and belief.
   I agree to provide the borrower with (i) confirmation of any transfer of funds through electronic funds transfer (EFT) or master check to the graduate or professional student borrower’s
   or dependent student’s account, and (ii) an opportunity to cancel or reduce any disbursement of a loan.
 21. Signature of Authorized School Official ____________________________________________________________                         22. Today’s Date (mm-dd-yyyy) _______________________________

     Name/Title (Printed or Typed) ____________________________________________________________________
                                                                                                                                        Please refer to the instructions for completing this form.
Instructions for Completing Federal PLUS Loan Information
and School Certification
Items 1 and 2 may be prefilled or completed               Item 10: Enter the maximum Federal PLUS Loan                Item 18: Enter the grade level of the graduate or
by the school.                                            amount the borrower wishes to borrow for himself/           professional student borrower or the dependent
                                                          herself or for the dependent undergraduate student          undergraduate student. Select the proper grade level
Item 1: Enter the code for your school. This code         listed in Item 12 for the loan period listed in Item 11.    indicator using the standard grade level
is provided by the U.S. Department of Education                                                                       codes provided:
for the Federal Family Education Loan Program.            Note to Borrower: Apply only for the amount you
                                                          will need to pay educational costs this year, keeping       Code Grade Level
Item 2: Enter your school name and address, and           in mind your ability to repay your loan(s). You may         1    Freshman/First-Year (including proprietary
the telephone number, including area code, of a           borrow up to the estimated cost of education at                  school programs that are less than one year
school official who can answer questions about            the school you or the student will attend minus any              in duration)
this certification.                                       estimated financial assistance that has been or will        2    Sophomore/Second-Year
Items 3-14 may be completed by the borrower,              be awarded during the period of enrollment.                 3    Junior/Third-Year
school, or lender. If the borrower is completing this     Item 11: Enter the beginning and ending dates of            4    Senior/Fourth-Year
section and any information has been prefilled            the academic period for which this loan is to be            5    Fifth-Year/Other Undergraduate (including
by the school or lender, the borrower should review       used.                                                            sixth-year undergraduate and continuing
it for correctness. If any part of the prefilled                                                                           education students)
                                                          Item 12: If the borrower is the parent of a                 A    First-Year Graduate or Professional
information is incorrect, cross out the incorrect         dependent undergraduate student, enter the
information and print the correct information.                                                                        B    Second-Year Graduate or Professional
                                                          student’s last name, first name, and middle initial.        C    Third-Year Graduate or Professional
Incorrect, incomplete, or illegible information may
delay the loan.                                           Item 13: If the borrower is the parent of a                 D     Beyond Third-Year Graduate or Professional
                                                          dependent undergraduate student, enter the                  Item 19: Enter the maximum amount of PLUS Loan
If the borrower is the parent of a dependent              student’s nine-digit Social Security Number. This           the borrower is eligible to receive for the academic
undergraduate student borrowing for the student’s         loan cannot be processed without the student’s              period covered in Item 17. This amount cannot
education, all references to “student” mean the           Social Security Number.                                     exceed the cost of attendance minus other financial
dependent undergraduate student named in Item 12.         Item 14: If the borrower is the parent of a                 aid.
Enter dates as month-day-year (mm-dd-yyyy). Use           dependent undergraduate student, enter the date
only numbers. Example: June 24, 1982 = 06-24-1982.                                                                    Item 20: Enter the disbursement dates for this
                                                          of the student’s birth. Be careful not to enter the         loan as determined in accordance with the Act.
Item 3: Enter or correct the borrower’s last name,        current year.
first name, and middle initial.                                                                                       Item 21: Your signature acknowledges that you
                                                          Items 15-22 are to be completed only by the school.         have read and agree to the provisions in the School
Item 4: Enter or correct the borrower’s Social            This information is to be certified by a financial aid      Certification. You must sign the certification and
Security Number. This loan cannot be processed            administrator or other school official authorized to        print your name and title.
without the borrower’s Social Security Number.            certify financial aid forms. If certification information
                                                                                                                      Item 22: Enter the date of certification.
Item 5: Enter the borrower’s permanent address            is transmitted electronically, the School Certification
(number, street, apartment number) or rural route         form does not have to be submitted.
number and box number, then city, state, and zip          Item 15: Indicate whether the graduate or                   Paperwork Reduction Notice
code. If the borrower’s mailing address is a post         professional student borrower or the dependent
                                                                                                                      According to the Paperwork Reduction Act of 1995,
office box or general delivery, list both the mailing     undergraduate student is (or plans to be) enrolled
address and the street address or rural route number                                                                  no persons are required to respond to a collection of
                                                          at least half time or full time. A graduate or
and box number.                                           professional student borrower who is enrolled (or           information unless it displays a currently valid OMB
                                                          planning to enroll) less than half time, or the parent      control number. The valid OMB control number for
Item 6: Enter the borrower’s area code and telephone
number. If the borrower does not have a telephone,        of a dependent undergraduate student who is                 this information collection is 1845-0069. The time
enter N/A.                                                enrolled (or planning to enroll) less than half time, is    required to complete this information is estimated
                                                          not eligible for a Federal PLUS Loan.                       to average 0.15 hours (9 minutes) per response,
Item 7: Enter the date of the borrower’s birth. Be
                                                          Item 16: Enter the date the student is expected to          including the time to review instructions, search
careful not to enter the current year.
                                                          complete the program at your school. If you are             existing data resources, gather and maintain the data
Item 8: Enter the borrower’s e-mail address.                                                                          needed, and complete and review the information
                                                          unsure of the actual completion date in the future,
Item 9: Enter the borrower’s lender selection (name,      enter the last day of the month.                            collection. If you have any comments concerning
identification number, city, and state), if known.                                                                    the accuracy of the time estimate(s) or suggestions
                                                          Item 17: Enter the dates covered by the cost of
Note to Borrower: If you do not have a lender for         attendance. These dates must coincide with actual           for improving this form, please write to:
this loan, contact the school’s financial aid office, a   term starting and ending dates. At a school without         U.S. Department of Education
bank or other financial institution, or the guarantor     academic terms, these dates must coincide with the          Washington, DC 20202-4537
or program listed on this form for information on         student’s program of study if that is less than an
lenders willing to make Federal PLUS Loans.               academic year in length, or the academic year.
       Addendum to the Federal Consolidation Loan Application and Promissory Note
                        Federal Family Education Loan Program

The College Cost Reduction and Access Act of 2007 (CCRAA) changed some of the terms of Federal
Consolidation Loans made under the Federal Family Education Loan Program (FFELP). As a result, certain
terms of the loan you receive under the accompanying Federal Consolidation Loan Application and
Promissory Note (Application and Promissory Note) differ from the terms in that document. The changes set
forth in this Addendum are incorporated into and made a part of the accompanying Application and
Promissory Note that you sign and the Borrower’s Rights and Responsibilities Statement.
•   Instructions for Completing the Federal Consolidation Loan Application and Promissory Note,
    Section E. Repayment Plan Selection. Effective July 1, 2009, a new paragraph E is added, to read as
    follows:
    “E. Income-Based Payments, in which your required monthly payment will be based on your income
    during any period when you have a partial financial hardship. The maximum repayment period under
    this plan may exceed 10 years. Eligible borrowers who meet certain requirements over a specified
    period of time may qualify for cancellation of any outstanding balance on their loans.”
•   Instructions for Completing the Federal Consolidation Loan Application and Promissory Note,
    Section E. Repayment Plan Selection, Note. Effective July 1, 2008, the Note in the instructions is
    revised to read as follows:
    “Note: You may apply for a Federal Consolidation Loan from any FFELP lender. Alternatively, if you
    are eligible for a Federal Consolidation Loan but: (1) you are unable to obtain a Federal Consolidation
    Loan or one with income-sensitive repayment terms that are acceptable to you; or (2) you wish to take
    advantage of the public service loan forgiveness program, you may apply for a Federal Direct
    Consolidation Loan from the U.S. Department of Education. If you already have a Federal
    Consolidation Loan, you may be eligible to consolidate that loan into a Federal Direct Consolidation
    Loan to take advantage of the public service loan forgiveness program. If your Federal Consolidation
    Loan has become delinquent and the lender has submitted the loan to the guaranty agency for default
    aversion assistance, you may be able to consolidate your loan into a Federal Direct Consolidation Loan
    to obtain an income-contingent repayment plan. The public service loan forgiveness program provides
    for the cancellation of the remaining balance due on eligible William D. Ford Federal Direct Loan
    Program loans, including Federal Direct Consolidation Loans, after you have made 120 payments (after
    October 1, 2007) on those Direct Loans under certain repayment plans while you are employed in certain
    public service jobs.”
•   Borrower’s Rights and Responsibilities Statement: Item 9. Deferment. Effective October 1, 2007,
    paragraph 3 is revised to read as follows:
    “A deferment is available for the period when I am serving on active duty during a war or other military
    operation or national emergency, or performing qualifying National Guard duty during a war or other
    military operation or national emergency and, if I am serving on or after October 1, 2007, for the 180-
    day period following the demobilization date for my qualifying service. Also, if I am a member of the
    National Guard or other reserve component of the Armed Forces (current or retired) who is called or
    ordered to active duty while I am enrolled at an eligible school, or within 6 months of having been
    enrolled, I am eligible for a deferment during the 13 months following the conclusion of my active duty
    service or until the date I return to enrolled student status, whichever is earlier.”




                                                                                                    12-14-2007
Federal Family Education Loan Program (FFELP)
                                                                                                                           Guarantor, Program, or Lender Identification                                         OMB No. 1845-0036
                                                                                                                                                                                                                Form approved

Federal Consolidation Loan                                                                                                                                                                                      Exp. date 01/31/2010


Application and Promissory Note
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any
accompanying documents is subject to penalties that may include fines, imprisonment, or both, under the
U.S. Criminal Code and 20 U.S.C. 1097.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW LOAN ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain,
verify, and record information that identifies each person who opens a loan account. What this means for you: Your name, address, date of birth, and other information collected in this form will be used to verify your identity. You may
also be asked to provide your driver’s license or other identifying documents.

Before You Begin
Read the Instructions for Completing the Federal Consolidation Loan Application and Promissory Note. Print using dark ink ballpoint pen or type. This form must be signed and dated by
the applicant.                        **PAGES 1, 2, AND 3 OF THIS FORM MUST BE SUBMITTED FOR YOUR APPLICATION TO BE PROCESSED.**
Section A. Borrower Information
 1. Last Name                                                                    First Name                                                        MI                 2. Social Security Number


3A. Permanent Address (Include Number, Street, Apartment Number; or Rural Route Number and Box Number, as applicable) City, State, Zip Code


3B. Permanent Mailing Address, if different from 3A. (Include P.O. Box or General Delivery, as applicable) City, State, Zip Code


 4. Area Code/Telephone Number                                                                                          5. Former Name(s)
    (        )
 6. Date of Birth (mm-dd-yyyy)                                                                                          7. Driver’s License State and Number
                                                                                                                           State                   #
 8. E-mail Address


 9. Employer Name


     Address


     City                                                                        State                          Zip Code                                                 Work Area Code/Telephone Number
                                                                                                                                                                         (        )
10. Consolidating Lender Name                                                                                                                                         11. Lender Code, if known


Section B. Reference Information
References: You must provide two separate references with different addresses who have known you for at least three years. Both references must be completed in full. Do not include
individuals who live with you (e.g., your spouse) or who live outside the United States.


12. Name                                     A.                                                                                               B.


    Permanent Address


    City, State, Zip Code


    E-mail Address (optional)


    Area Code/Telephone Number                    (            )                                                                                    (             )


    Relationship to Borrower

Section C. Promissory Note (To be completed and signed by the borrower.)
(In this Promissory Note, “lender” refers to, and this Promissory Note benefits, the original consolidating lender and its successors and assigns, including any subsequent holder of this
Promissory Note.)
13. Promise to Pay:
I promise to pay to the order of the lender all sums disbursed (hereafter “loan”) under the terms of this Promissory Note (hereafter “Note”) to pay off my prior loan obligations, plus
interest and other charges and fees that may become due as provided in this Note. Unless I make interest payments, interest that accrues on my loan during forbearance periods and
on the unsubsidized portion of my loan during deferment periods may be added, as provided under the Act, to the principal balance of my loan. If I do not make any payment on this Note
when it is due, I will also pay reasonable collection costs, including but not limited to attorney’s fees, court costs, and other fees.
I will not sign this Note before reading the entire Note, even if I am told not to read it, or told that I am not required to read it. I am entitled to an exact copy of this Note and the Borrower’s
Rights and Responsibilities Statement. My signature certifies I have read, understand, and agree to the terms and conditions of this Note, including the Borrower Certification and
Authorizations and the Borrower’s Rights and Responsibilities Statement.

I UNDERSTAND THAT THIS IS A LOAN THAT I MUST REPAY.

14. Borrower’s Signature                                                                                                                                                Today’s Date (mm-dd-yyyy)


                                                                                                       Submit pages 1, 2, and 3
                                                                                                             Page 1 of 8
Borrower Name                                                                                               Social Security Number
Please print.

Section D.1. Education Loan Indebtedness — Loans You Want to Consolidate
Read the instructions before completing this section. List each federal education loan you want to consolidate, including each loan (if any) currently held by the lender that will be
consolidating your loans. Use the Loan Codes listed in the instructions. The loan holder/servicer is the entity to which you send your payments. If you need to list additional loans, use the
Additional Loan Listing Sheet included in this package. (If an Additional Loan Listing Sheet is not included, you may obtain one from your consolidating lender.) List each loan separately.
Please print. ONLY LIST LOANS THAT YOU WANT TO CONSOLIDATE IN THIS SECTION.

15. Loan Code        16. Loan Holder/Servicer Name and Mailing Address                                       17. Loan Account Number             18. Interest Rate 19. Estimated Payoff Amount
(See Instructions)   (See Instructions)




20. Grace Period End Date – If any of the loans that you have selected for consolidation are in a grace period, you can delay
the processing of your Federal Consolidation Loan until the end of your grace period by entering your expected grace period end                 (month/year)
date in the space provided. If you leave this field blank, your Federal Consolidation Loan will be processed and any selected loans
that are in a grace period will enter repayment immediately upon consolidation.

Section D.2. Education Loan Indebtedness — Loans You Do Not Want to Consolidate
Read the instructions before completing this section. List each education loan that you are not consolidating but want considered in calculating your maximum repayment period.
Remember to include each loan (if any) held by the lender that will be consolidating your loans, but that you do not want to include in your Federal Consolidation Loan. Use the Loan Codes
listed in the instructions. The loan holder/servicer is the entity to which you send your payments. If you need to list additional loans, use the Additional Loan Listing Sheet included in this
package. (If an Additional Loan Listing Sheet is not included, you may obtain one from your consolidating lender.) List each loan separately. Please print. ONLY LIST LOANS THAT YOU DO
NOT WANT TO CONSOLIDATE IN THIS SECTION.
21. Loan Code        22. Loan Holder/Servicer Name and Mailing Address                                       23. Loan Account Number             24. Interest Rate 25. Current Balance
(See Instructions)   (See Instructions)




                                                                                    Submit pages 1, 2, and 3
                                                                                          Page 2 of 8
Borrower Name                                                                                             Social Security Number
Please print.

Section E. Repayment Plan Selection (Check one box below.)
Before completing this section, carefully read the instructions for Item 26 and any supplemental materials on repayment options provided by your lender. If you have any questions or need
additional information, contact the lender that will be consolidating your loans. If you do not complete this item, the consolidating lender will provide a standard payment schedule that
does not exceed the maximum repayment period allowable for the amount of your loan.

26. Repayment Options (Check the box that corresponds to your repayment plan selection.):
     A.   q     Standard Payments               B.   q   Graduated Payments            C.   q   Income-sensitive Payments              D.   q   Extended Payments
Section F. Borrower Certification and Authorizations
27. Under penalty of perjury, I certify that:                                                        unpaid accrued interest, and other costs as permitted by federal regulations in the
A. The information I have provided on this Federal Consolidation Loan Application                    payoffs reported to the consolidating lender. I understand that if any collection
   and Promissory Note and as updated by me from time to time is true, complete,                     costs are owed on the loans selected for consolidation, these costs may be
   and correct to the best of my knowledge and belief and is made in good faith.                     added to the principal balance of the Federal Consolidation Loan and, in the case
                                                                                                     of Federal Stafford, SLS, PLUS, or Consolidation loans in default and held by a
B. I do not have any other application pending for a Federal Consolidation Loan.                     guaranty agency, may not exceed 18.5 percent of the outstanding principal and
C. All of the loans selected for consolidation have been used to finance my education                interest on the loan at the time the holders certify the payoff amounts.
   or the education of my dependent student(s).                                                  B. I understand that I may no longer be eligible for some deferments and for subsidized
D. All of the loans selected for consolidation are in a grace period or in repayment                deferment periods on some loans being consolidated. I also understand that I may
   (including loans in deferment or forbearance).                                                   no longer be eligible for some loan discharges and types of forgiveness that were
E. If I have an outstanding Federal Consolidation Loan, I am eligible for another                   available on the loans being consolidated.
   Federal Consolidation Loan because: (i) I have another eligible loan(s), or (ii) I am         C. I authorize the consolidating lender to contact the holders identified on my
   consolidating a Federal Consolidation Loan with at least one other eligible loan.                application to determine the eligibility and/or payoff amounts for the loans I
                                                                                                    have selected for consolidation. I further authorize those holders to release that
F. If I owe an overpayment on a Federal Perkins Loan, Federal Pell Grant, Federal                   information.
   Supplemental Educational Opportunity Grant, Academic Competitiveness Grant
   (ACG), National Science or Mathematics Access to Retain Talent (SMART) Grant,                 D. I authorize the consolidating lender to send the proceeds of my Federal Consolidation
   or Leveraging Educational Assistance Partnership Grant, I have made satisfactory                 Loan to each holder of the loans I have identified to pay off the debts.
   arrangements with the holder to repay the amount owed.                                        E. If the amounts my consolidating lender sends to my holders exceed the amounts
G. I am not now in default on any loan that I am consolidating, or, if I am in default,             needed to pay off the balances of the selected loans, I understand that the holders
   I have either (a) made satisfactory arrangements with the holder of the defaulted                will refund the excess to my consolidating lender to be applied against the
   loan(s) to repay the amount owed, or (b) for Federal Stafford, SLS, PLUS, or                     outstanding balance of this loan. If the amounts my consolidating lender sends to
   Consolidation loans, I agree to repay the Federal Consolidation Loan under                       my holders are less than the amounts needed to pay off the balances of the loans
   income-sensitive repayment terms.                                                                selected for consolidation, I will be responsible for notifying my consolidating lender
                                                                                                    about the remaining amounts. I authorize the consolidating lender to include the
H. If I have been convicted of, or pled nolo contendere (no contest) or guilty to, a                remaining amounts in this Federal Consolidation Loan, unless I pay off the remaining
   crime involving fraud in obtaining federal student assistance under Title IV of the              balances.
   Higher Education Act of 1965, as amended, I have completed the repayment of
   those funds to the U.S. Department of Education (the Department), or to the loan              F. I authorize the consolidating lender, the guarantor, or their agents to investigate
   holder in the case of a Title IV federal student loan.                                           my credit record and report information concerning my loan status to persons and
                                                                                                    organizations permitted by law to receive such information.
I. I am not subject to a judgment secured through litigation or to an order for wage
     garnishment, except as I have disclosed.                                                    G. I authorize the release of information pertinent to my loan: (i) by the school(s),
                                                                                                    the lender, and the guarantor, or their agents, to the references on this loan and to
                                                                                                    members of my immediate family unless I submit written directions otherwise; and
28. I make the following authorizations and statements of understanding:                            (ii) by and among my schools, lenders, guarantors, the Department, and their agents.
A. I understand that the amount of my Federal Consolidation Loan will be based                   H. If I have HEAL loans serviced by the consolidating lender and such loans are not
    on the payoff amounts of my outstanding eligible loans that I selected for                      included in this Federal Consolidation Loan, I authorize the establishment of a
    consolidation, as provided by the holders of those loans, and may exceed my                     combined payment plan on my behalf.
    estimate of such payoff amounts. The actual payoff amounts may differ from
    the estimated payoff amounts because the holders will include unpaid principal,

                          Review your Federal Consolidation Application and Promissory Note to ensure you completed all sections, including Section E above.




                                                                                   Submit pages 1, 2, and 3
                                                                                         Page 3 of 8
Federal Consolidation Loan Application and Promissory Note (continued)
Disclosure of Terms                                                                                  Repayment
This Note applies to Federal Consolidation Loans made under the Federal Family Education             I must repay the full amount of the loan made under this Note and the accrued interest.
Loan Program. In this Note, the Higher Education Act of 1965, as amended (20 U.S.C.                  Repayment begins upon disbursement of the loan, and my first payment will be due within
1070 et seq.), and applicable U.S. Department of Education regulations are collectively              60 days after the disbursement.
referred to as the “Act.” In this Note, references to “the Department” mean the U.S.
                                                                                                     Payments will be scheduled in monthly installments according to the disclosure my lender
Department of Education.
                                                                                                     will provide to me. The disclosure will state my payment amounts and due dates. The
At or about the time my Federal Consolidation Loan is disbursed, a disclosure statement              maximum scheduled repayment period may be up to 30 years in length, depending upon
and repayment schedule (“disclosure”) will be provided to me. This disclosure will                   the amount of my student loans and my repayment plan. The minimum payment on my
identify my Federal Consolidation Loan amount and additional terms of the loan. If I have            loan must equal at least the amount of interest that accrues between scheduled payments.
questions about the information disclosed, I will contact the lender. If the information in
                                                                                                     Payments submitted by me or on my behalf (exclusive of refunds) may be applied first to
this Note conflicts with information in the disclosure, the specific terms and information in
                                                                                                     late charges and collection costs that are due, then to accrued interest that has not been
the disclosure apply to my loan.
                                                                                                     capitalized, and finally to the principal amount. If I am unable to make my scheduled loan
Important additional terms of this loan are disclosed in the Borrower’s Rights and                   payments, the lender may allow me to reduce my payment amount, extend the time for
Responsibilities Statement accompanying this Note.                                                   making payments, or temporarily stop making payments as long as I intend to repay my
                                                                                                     loan. Allowing me to temporarily delay or reduce my loan payment is called forbearance.
I agree that the lender may sell or assign my loan to another eligible holder.
                                                                                                     The lender may grant me a forbearance to align payment due dates on my loans or to
Interest                                                                                             eliminate a delinquency that persists even though I am making scheduled payments.
Unless my lender notifies me in writing of a lower rate(s), the rate(s) of interest for my           I may prepay all or any part of the unpaid balance on my loan at any time without penalty.
loan is that specified in the Act. Interest rate information is presented in the Borrower’s          Upon payment in full of this Note, I agree to accept written notification of the payoff in
Rights and Responsibilities Statement accompanying this Note. The interest rate is                   place of receiving the original Note.
presented in a disclosure that is provided to me.
                                                                                                     Acceleration and Default
Interest accrues on the unpaid principal balance of my Federal Consolidation Loan from
                                                                                                     At the option of the lender, the entire unpaid balance will become immediately due and
the date of disbursement by the lender until the entire principal balance is paid in full. This
                                                                                                     payable when either of the following events occurs: (i) I make a false representation that
includes interest accruing during any period of deferment or forbearance. I agree to pay all
                                                                                                     results in my receiving a loan for which I am not eligible; or (ii) I default on the loan.
interest charges on my loan except for interest payable by the federal government under
the Act.                                                                                             The following events shall constitute a default on my loan: (i) I fail to pay the entire unpaid
                                                                                                     balance after the lender has exercised its option under item (i) in the preceding paragraph,
I will be responsible for the interest that begins accruing upon disbursement of my loan.
                                                                                                     (ii) I fail to make installment payments when due and my failure persists for at least 270
If I do not make payments of interest before the beginning of principal repayment, or
                                                                                                     days, or (iii) I fail to comply with other terms of the loan, and the lender or guarantor
during a period of authorized deferment or forbearance, I agree that the lender may
                                                                                                     reasonably concludes I no longer intend to honor my repayment obligation. If I default, the
capitalize such interest to the extent permitted by the Act.
                                                                                                     guarantor may purchase my loan and capitalize all outstanding interest into a new principal
Except for any portion of the Federal Consolidation Loan attributable to a HEAL Loan,                balance. The new principal balance and collection fees will become immediately due
this loan will bear simple interest at an annual rate that is fixed for the term of the loan.        and payable.
The maximum interest rate on this loan will be equal to the weighted average of the
                                                                                                     If I default, the default will be reported to all national credit bureaus and will significantly
interest rates (as certified by the holder) on the loans being consolidated, rounded up to
                                                                                                     and adversely affect my credit history. I acknowledge that a default will have additional
the nearest higher one-eighth of one percent, not to exceed 8.25 percent.
                                                                                                     adverse consequences to me as disclosed in the Borrower’s Rights and Responsibilities
If I choose to consolidate a fixed rate Federal ALAS/SLS Loan(s) or Federal PLUS Loan(s),            Statement. Following default, the loan may be subject to income-contingent repayment
I request that the existing interest rate of each loan be converted before consolidation to          (including potential collection of amounts in excess of the principal and interest) in
the refinancing rate provided for in the Act, if that rate is lower than the existing rate. If my    accordance with the Act.
lender grants this request, I understand there will be no separate document evidencing this
                                                                                                     Governing Law and Notices
refinancing.
                                                                                                     The terms of this Note will be interpreted according to the Act, other applicable federal
For the portion of the Federal Consolidation Loan attributable to a HEAL loan (if applicable),
                                                                                                     statutes and regulations, and the guarantor’s policies. Applicable state law, except as
the interest rate is a variable rate and is adjusted annually on July 1. The variable rate for
                                                                                                     preempted by federal law, may provide for certain borrower rights, remedies, and defenses
each 12-month period will be equal to the average of the bond equivalent rates of the
                                                                                                     in addition to those stated in this Note.
91-day Treasury Bills auctioned for the quarter ending June 30, plus 3.0 percent; there is
no maximum interest rate on this portion of the loan.                                                If I reside in the state where the guarantor’s principal office is located, the guarantor may
                                                                                                     sue to enforce the loan in the county where the guarantor’s office is located. However,
180-Day Add-On Provision
                                                                                                     if I object to being sued there and I mail a written objection to the guarantor that is
If I do not consolidate all eligible loans at this time, I understand that I may later add to        postmarked no later than 30 days after I am served with the lawsuit, the guarantor will
this Federal Consolidation Loan an eligible loan(s) made before or after the date of this            either have the court transfer the lawsuit to the county where I live or will dismiss
consolidation. To add an eligible loan(s), I understand I must complete a Request to Add             the lawsuit.
Loans form which is available from the lender and which must be received by the lender
                                                                                                     Any notice required to be given to me will be effective if sent by first class mail to the latest
within 180 days after the date this Federal Consolidation Loan is disbursed. If I add a
                                                                                                     address the lender has for me or by electronic means to an address that I have provided.
loan during this period, the lender will disclose new terms to me. The new terms and
                                                                                                     I will immediately notify the lender of any change of address or status as specified in the
information will supersede the terms and information in any prior disclosure. After the
                                                                                                     Borrower’s Rights and Responsibilities Statement. Failure by the lender to enforce or
180-day period, no loan can be added to this Federal Consolidation Loan and I will need to
                                                                                                     insist on compliance with any term of this Note shall not waive any right of the lender.
apply for a new Federal Consolidation Loan to consolidate any eligible loan(s).
                                                                                                     No provision of this Note may be modified or waived except in writing by the lender of
Late Charges and Collection Costs                                                                    the Note. If any provision of this Note is determined to be unenforceable, the remaining
The lender may collect from me: (i) a late charge for each late installment payment if I fail        provisions remain in force.
to make any part of a required installment payment within 15 days after it becomes due,
and (ii) any other charges and fees that are permitted by the Act for the collection of my
loans. If I default on the loan, I will pay reasonable collection fees and costs, plus court
costs and attorney’s fees.




                                                                                              Page 4 of 8
 Federal Family Education Loan Program (FFELP)
                                                                                                  Guarantor, Program, or Lender Identification


 Instructions for Completing the Federal Consolidation Loan Application
 and Promissory Note

 Before You Begin                                                                                    Section D. Education Loan Indebtedness

Before beginning, gather all of your education loan records, account statements, and                Education Loans
bills so that you have the information you need to complete the Federal Consolidation
Loan Application and Promissory Note.                                                               The following types of education loans (except those represented by the code OTHER)
                                                                                                    are eligible for consolidation:
Print using a dark ink ballpoint pen or type. Enter dates as month-day-year
(mm-dd-yyyy). Use only numbers. Example: June 24, 1982 = 06-24-1982. This form                      Loan Code             Education Loans
must be signed and dated by the applicant. If an item has been completed for you and                SS        Subsidized Federal Stafford Loans
it is incorrect, cross out the incorrect information and print the correct information.             DSS       Direct Subsidized Stafford/Ford Loans
Incorrect or incomplete information may delay processing of your application.                       US        Unsubsidized and Nonsubsidized Federal Stafford Loans
                                                                                                    DUS       Direct Unsubsidized Stafford/Ford Loans
If you have any questions about completing this application, contact the entity                     PLUS      Federal PLUS Loans (for parents)
identified above.                                                                                   GB        Federal PLUS Loans (for graduate/professional students)
                                                                                                    DPLUS     Direct PLUS Loans (for parents)
 Section A. Borrower Information                                                                    D3        Direct PLUS Loans (for graduate/professional students)
                                                                                                    SLS       Federal Supplemental Loans for Students
Item 1: Enter or correct your last name, first name, and middle initial.                            PERK      Federal Perkins Loans and National Direct Student Loans
Item 2: Enter or correct your Social Security Number.                                               SCON      Subsidized Federal Consolidation Loans
                                                                                                    DSCON     Direct Subsidized Consolidation Loans
Item 3: Enter your permanent address (number, street, apartment number, or rural
                                                                                                    UCON      Unsubsidized Federal Consolidation Loans
route number and box number, then city, state, zip code). If your mailing address
                                                                                                    DUCON     Direct Unsubsidized Consolidation Loans, including Direct PLUS
is a post office box or general delivery, you must list your mailing address in 3B, in
                                                                                                              Consolidation Loans
addition to your home address in 3A.
                                                                                                    HPSL      Health Professions Student Loans, including Loans for
Item 4: Enter the area code and telephone number at which you can most easily                                 Disadvantaged Students
be reached. (Do not list your work telephone number here.) If you do not have a                     HEAL      Health Education Assistance Loans
telephone, enter N/A.                                                                               FISL      Federal Insured Student Loans
Item 5: Enter any former names under which one or more of your loans may have                       NSL       Federal Nursing Loans
been disbursed. If you do not have a former name, enter N/A.                                        OTHER     Other education loans not eligible for consolidation that you want used to
                                                                                                              calculate the maximum repayment period
Item 6: Enter the date of your birth. Be careful not to enter the current year.
Item 7: Enter the two-letter abbreviation for the state that issued your driver’s license           Information you need to answer items in this section is available in loan documents,
followed by the driver’s license number. If you do not have a driver’s license, enter               such as:
N/A.                                                                                                n The last monthly billing statement you received,
Item 8: Enter your preferred e-mail address for receiving communications. You are                   n Your quarterly interest statement or annual statement,
not required to provide this information. If you do, the lender or holder of your loan              n Your coupon book, or
may use your e-mail address to communicate with you. If you do not have an e-mail
address, or do not wish to provide it, enter N/A.                                                   n The Internet site of your loan holder or servicer.

Item 9: It is important that the consolidating lender is able to reach you during the               If you are unsure of the correct information on your loans, contact the entity to which
process of making your loan and during repayment. Enter your employer’s name,                       you send your payments or check the most recent correspondence from that entity.
address (including number, street, suite number, city, state, and zip code), and your               You may also obtain information on your loan(s) by accessing the National Student
work telephone number (or the number of your work cellular telephone or other                       Loan Data System at http://www.nslds.ed.gov.
wireless device). If you are self-employed, enter the name, address, and telephone
number of your business (or the number of your business cellular telephone or other                 Step 1: Begin by listing (according to the instructions that follow for Items 15-19)
wireless device). If you are not employed, enter N/A.                                               eligible loan(s) that you wish to consolidate, including any loan(s) currently held by the
                                                                                                    lender that will be consolidating your loan(s). You may consolidate a Federal Consolidation
Item 10: Enter the name of the lender you would like to finance your Federal                        Loan only if you are combining that loan with at least one other eligible loan.
Consolidation Loan.
                                                                                                    If you are in default on any loan that you wish to consolidate, you must have made
Item 11: Enter the lender code, if known. Otherwise, leave this item blank.                         satisfactory repayment arrangements with the holder to repay the loan before it is
                                                                                                    eligible for consolidation. Satisfactory arrangements usually involve making a series
 Section B. Reference Information                                                                   of payments on the defaulted loan. For Federal Stafford, Federal SLS, Federal PLUS,
                                                                                                    or Federal Consolidation loans, satisfactory repayment arrangements involve making
Items 12A and 12B: Enter the requested reference information for two adults with                    a series of reasonable and affordable payments or agreeing to repay the new Federal
different addresses who have known you for at least three years. References with                    Consolidation Loan under an income-sensitive repayment plan. Contact the holder of
addresses outside the United States are not acceptable. Do not include individuals                  your defaulted loan for specific information.
who live with you. If a reference does not have a telephone number or e-mail address
or does not wish to provide an e-mail address, enter N/A. If you provide an e-mail                  Item 15: Enter the code that corresponds to the loan type from the Education Loans
address for a reference, the lender or holder of your loan may use it to communicate                list. If you are not sure about the loan type, leave this item blank.
with the reference. All requested items must be completed or processing of your                     Item 16: Enter the full name and mailing address of the holder of each of your federal
application will be delayed.                                                                        education loans or the holder’s servicer. (This is the address to which you are or will
                                                                                                    be sending your payments.) Do not use initials instead of full names. For a defaulted
 Section C. Promissory Note                                                                         FFELP loan, the holder is the guaranty agency or the Department of Education. For a
                                                                                                    defaulted Federal Direct Loan, the holder is the Department of Education. For a Perkins
This is a legally binding contract.                                                                 Loan, the holder is the school.
Item 13: Carefully read the entire Promissory Note, Borrower Certification and                      Item 17: Enter the account number for each loan. This may be listed on your
Authorization, Borrower’s Rights and Responsibilities Statement, and the other                      monthly billing statement or coupon or in other information your holder or
materials provided in connection with this loan.                                                    holder’s servicer provides.
Item 14: Sign and date the Promissory Note.                                                         Item 18: Enter the interest rate you are paying on each loan.
Note: Signature is required. If you fail to sign the Promissory Note, your application              Item 19: Enter the estimated payoff amount, including any unpaid interest, late fees,
will be delayed.                                                                                    and collection costs.
                                                                                                                                                                        Continued on next page.

                                                                                            Page 5 of 8
Item 20: If you are in your grace period (the specified period of time after a student           Section F. Borrower Certification and Authorization
graduates, leaves school, or drops to less than half-time enrollment during which
loan payments are not required and during which interest on loans may be payable                Items 27 and 28: Read these items carefully. The statements confirm the accuracy
by the federal government) for any of the loans selected for consolidation and you              of information that you supply, authorize various parties to perform certain functions,
wish to delay processing until you have completed your grace period, enter the month            and certify your understanding and acceptance of certain terms and conditions of
and year that your grace period ends. If you request such a delay, processing of your           the loan.
Federal Consolidation Loan will begin approximately 60-90 days before the latest
grace period end date. If you leave this field blank, the processing of your Federal             Submitting Your Application and Promissory Note
Consolidation Loan will not be delayed and any selected loans that are in a grace
period will enter repayment immediately upon consolidation.                                     Review all information on your Federal Consolidation Loan Application and Promissory
                                                                                                Note. Return pages 1 through 3 of your completed application and promissory note to
Step 2: The maximum length of your Federal Consolidation Loan repayment period is               your consolidating lender for processing. Keep a copy for your records. Remember
determined by your total education loan debt, including:                                        to continue making your regularly scheduled education loan payments until your
n Loans you are consolidating,                                                                  consolidating lender notifies you that the consolidation is complete. If you would
                                                                                                like to temporarily postpone your payments while your Federal Consolidation Loan
n Loans eligible for consolidation that you are not consolidating, and                          is being processed, contact your holder(s) regarding forbearance. When your loans
n Loans not eligible for consolidation.                                                         are consolidated, you will receive a repayment schedule and disclosure statement for
                                                                                                your Federal Consolidation Loan. It will provide information about your new loan and
In Items 21-25, list eligible loans you do not wish to consolidate and outstanding
                                                                                                instructions on where to send your monthly payments.
education loans not eligible for consolidation that you want used to determine
your maximum repayment period. Outstanding education loans not eligible for
                                                                                                Mailing Instructions: Mail the original copy of the Federal Consolidation Loan
consolidation must have been made exclusively to finance postsecondary education
                                                                                                Application and Promissory Note and the Additional Loan Listing Sheet, if applicable,
by an entity such as a bank, school, or state agency under a public or private loan
                                                                                                to your consolidating lender.
program. Personal loans from family or friends or loans in default may not be listed.
The amount of the loans that are not included in the Federal Consolidation Loan but
are used to determine your repayment period will not exceed the amount of the
loans consolidated.

 Section E. Repayment Plan Selection

Item 26: You may choose one of several repayment plans for your Federal
Consolidation Loan. (Refer to supplemental materials provided by the consolidating
lender or call the lender for more information on repayment options.) If you do not
complete this item, the lender will provide a standard payment schedule that does
not exceed the maximum allowable repayment period for which you are eligible.
The maximum repayment period is 10 to 30 years depending on the amount of your
student loans listed in Sections D.1 and D.2. Your maximum repayment period will be
based on your student loan debt; however, you may request a repayment period that is
shorter than the maximum period allowed. A shorter repayment period will reduce the
amount of interest you will pay over the life of the loan.
Your repayment plan options include:
A. Standard Payments in which you will make equal monthly payments. The final
   payment may be slightly larger or smaller.
B. Graduated Payments in which your monthly payments will be smaller in the
   beginning of repayment and gradually increase in stages over the course of the
   repayment period.
C. Income-sensitive Payments in which the amount of your monthly payments will
   be adjusted annually based on your expected total monthly gross income from
   employment and all other sources. Payments may increase or decrease. If you
   select this option, your initial repayment amount will be based on a standard or
   graduated payment plan unless otherwise specified in accompanying materials.
   After your Federal Consolidation Loan is made, you will be required to submit
   additional information to assist the lender in determining your income-sensitive
   payment.
D. Extended Payments in which you may repay over a 25-year period on a standard
   or graduated payment plan if you have FFELP loans totalling more than $30,000.
   Under the other repayment options available in the consolidation program, you
   must have at least $40,000 in debt to qualify for a 25-year repayment period. If you
   have debt in excess of $60,000 and wish to repay over a 30-year period, you should
   select one of the other repayment options (A-C).
Note: You may apply for a Federal Consolidation Loan from any FFELP lender.
Alternatively, if you are eligible for a FFELP consolidation loan and you are unable to
obtain a Federal Consolidation Loan or a Federal Consolidation Loan with income-
sensitive repayment terms that are acceptable to you, you may apply for a Federal
Direct Consolidation Loan from the U.S. Department of Education. In addition, if
you have a Federal Consolidation Loan that has become seriously delinquent or
that has defaulted, you may be eligible to consolidate that loan into a Federal Direct
Consolidation Loan for the purpose of obtaining an income-contingent repayment plan.




                                                                                        Page 6 of 8
Borrower’s Rights and Responsibilities Statement
Important Notice: The Borrower’s Rights and Responsibilities Statement provides additional information about the terms and conditions of your Federal Consolidation Loan.
Please retain this Statement for your records. You may contact your lender at any time for another copy of this Statement.

The Federal Family Education Loan Program (FFELP) includes the following loans:                     n An increase in my interest rate,
n Subsidized Federal Stafford Loan,                                                                 n Loss of eligibility for other student aid and assistance under most federal benefit
n Unsubsidized Federal Stafford Loan,                                                                 programs,

n Federal Insured Student Loan (FISL),                                                              n Loss of eligibility for loan deferments, and

n Federal Supplemental Loans for Students (SLS),                                                    n Negative credit reports to credit bureaus.

n Federal PLUS Loan, and                                                                            NOTE: To avoid the consequences of default, I may be eligible to consolidate a Federal
                                                                                                    Consolidation Loan that has become seriously delinquent or that has defaulted through the
n Federal Consolidation Loan.
                                                                                                    U.S. Department of Education’s Federal Direct Consolidation Loan Program for the purpose
The FFELP is authorized by Title IV, Part B of the Higher Education Act of 1965 as amended.         of obtaining an income-contingent repayment plan.

1. Governing Law – A loan disbursed under this Federal Consolidation Loan Promissory                7. Credit Bureau Notification – Information concerning the amount, disbursement, and
Note (Note) is subject to the Higher Education Act of 1965, as amended (20 U.S.C. 1070 et           repayment status (current or delinquent) of my loan will be reported by my lender to one
seq.), and applicable U.S. Department of Education regulations (collectively referred to as         or more national credit bureaus on a regular basis. If I default on my loan, the default
the “Act”).                                                                                         will also be reported by the guarantor to all national credit bureaus. Before the guarantor
                                                                                                    reports such a default, it will give me at least 30 days notice that default information will
2. Change of Status – I must notify my lender or any subsequent holder of my loan if any of         be disclosed to the credit bureaus unless I enter into a repayment arrangement within 30
the following events occurs:                                                                        days of the date of the notice. The guarantor will give me a chance to ask for a review of the
n I change my address, e-mail address, or telephone number,                                         debt before the default is reported. My lender or guarantor, as applicable, must provide a
                                                                                                    timely response to a request from any credit organization regarding objections I might raise
n I change my name (for example, maiden name to married name),
                                                                                                    with that organization about the accuracy and completeness of information reported by the
n I change my employer or my employer’s address or telephone number changes, or                     lender or guarantor.
n I have any other change in status that would affect my loan (for example, the loss of             8. Loan Discharge & Forgiveness – My loan will be discharged if documentation of my
   eligibility for an unemployment deferment by obtaining a job).                                   death is submitted to my lender. If I am consolidating a PLUS Loan and the dependent
3. Interest Rate – The interest rate on a Federal Consolidation Loan is based on the                student for whom I borrowed the PLUS Loan dies, the portion of my Federal Consolidation
weighted average of the interest rates on the loans being consolidated rounded up to the            Loan attributable to that PLUS Loan will be discharged if documentation of the dependent
nearest higher one-eighth of one percent, not to exceed 8.25%. This fixed interest rate             student’s death is submitted to my lender.
remains the same throughout the life of the loan. For the portion of a Federal Consolidation        My loan may also be discharged if a physician certifies that I am totally and permanently
Loan attributable to a HEAL loan, the interest rate is a variable rate, adjusted annually on        disabled as defined by the Act. In addition, I must meet certain employment earnings
July 1. The variable rate is equal to the average of the bond equivalent rates of the 91-day        requirements and may not receive any additional FFELP, Direct, or Federal Perkins loans
Treasury Bills auctioned for the quarter ending June 30, plus 3.0%; there is no maximum             during a 3-year conditional discharge period. I may not receive a discharge due to total
interest rate on this portion of the loan. The interest rate of my Federal Consolidation Loan       and permanent disability based on a condition that existed before the loans that are being
will be disclosed to me at or about the time my loan is disbursed.                                  consolidated were made, unless a physician certifies that the condition substantially
4. Payment of Interest – It is my responsibility to pay interest on the unpaid principal            deteriorated after the loans that are being consolidated were made.
amount of my loan. Interest will be charged from the date my Federal Consolidation Loan             I understand that I may not qualify for a disability discharge of my Federal Consolidation
is disbursed. The federal government will pay interest that accrues during deferment on             Loan if any loan I am consolidating does not meet the discharge conditions.
the portion of my Federal Consolidation Loan that repays subsidized Federal Stafford
Loans, subsidized Federal Direct Stafford Loans, subsidized FISL loans, subsidized                  My loan will not be automatically discharged in bankruptcy. To discharge a loan in
Federal Consolidation Loans, and subsidized Federal Direct Consolidation Loans. I will              bankruptcy, I must prove undue hardship in an adversary proceeding before the
be responsible for interest that accrues during deferment on the portion of my Federal              bankruptcy court.
Consolidation Loan that repays other loan types.
I am responsible for paying the interest that accrues during a forbearance period.                  In certain cases, the Act provides for discharge of all or a portion of my Federal
                                                                                                    Consolidation Loan if:
If I inform my lender that I wish to pay interest as it accrues, but I do not make any
payments, my lender may capitalize that interest. Capitalized interest increases the principal      n One or more FFELP, Direct, or Federal Perkins loans that I consolidated were used to pay
balance of my loan and the total amount of interest charges I must pay.                               for a course of study that I was unable to complete because my school closed, or
                                                                                                    n My eligibility for one or more FFELP or Direct loans that were consolidated was (i) falsely
Interest on my loan may be capitalized to the extent permitted by the Act. Generally,                 certified by my school or (ii) falsely certified as a result of a crime of identity theft.
capitalization may occur no more frequently than quarterly.
                                                                                                    The Act also provides for discharge in the amount of any required refund of a FFELP
I may be able to claim a federal income tax deduction for interest payments I make on my            or Direct loan that my school failed to make to my loan holder on my behalf.
FFELP loans. For further information, I may refer to the IRS Publication 970 available at
http://www.irs.gov.                                                                                 Neither the lender, the guarantor, nor the Department of Education vouch for the quality or
                                                                                                    suitability of the academic programs offered by participating schools. Unless I qualify for
5. Sale or Transfer of Loan – The lender may sell or otherwise transfer my loan without             loan discharge under the Act, I must repay this loan even if I do not complete my education,
my consent. Should ownership of my loan be transferred, I will be notified of the name,             I am unable to obtain employment in my field of study, or I am dissatisfied with, or do not
address, and telephone number of the new lender if the address to which I must make                 receive, the education I paid for with the loan(s) being consolidated.
payments changes. Sale or transfer of my loan does not affect my rights and responsibilities
under the loan.                                                                                     If I am a full-time teacher and at the time I obtained a subsidized or unsubsidized Stafford
                                                                                                    Loan that I am consolidating I had no outstanding balance on a Title IV loan disbursed
6. Consequences of Default – Default is defined in detail in my Note. If I default, the entire      before October 1, 1998, I may be eligible for forgiveness under the Teacher Loan
unpaid balance and collection fees will become immediately due and payable. Failure to repay        Forgiveness Program. A fixed amount of my Stafford loan(s) that I am consolidating may
this loan according to its terms and conditions may result in any or all of the following:          be repaid if I have worked as a full-time teacher for five consecutive school years and if I
n Loss of federal and state income tax refunds,                                                     meet all other eligibility requirements under the Act.

n Loss of other federal or state payments,                                                          I understand that, by consolidating, I may forego some discharges that might otherwise be
                                                                                                    available for the loan(s) being consolidated.
n My employer withholding part of my wages to give them to my guarantor (administrative
  wage garnishment),                                                                                9. Deferment – Under certain circumstances, I have a right to defer (postpone) repayment.
n Legal action against me,                                                                          Upon request, my lender will provide me with a deferment application that explains the
                                                                                                    eligibility requirements. If I am in default on my Federal Consolidation Loan, I am not eligible
n Collection charges (including attorney’s fees) being assessed against me,
                                                                                                    for deferment unless I make payment arrangements satisfactory to my lender before the
n Loss of my professional license,                                                                  payment of a default claim on the loan.

                                                                                            Page 7 of 8
If I consolidate all of my eligible FFELP loans, deferments are available while I am:                   IMPORTANT NOTICES
n Enrolled at least half time at an eligible school,                                                    Privacy Act Notice
n Engaged in a full-time course of study in a graduate fellowship program,                              The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided
n Engaged in a full-time rehabilitation training program for individuals with disabilities              to you:
  (if the program is approved by the Department of Education),
                                                                                                        The authority for collecting the requested information from and about you is §421 et seq.
n Conscientiously seeking, but unable to find, full-time employment (for up to three years),            of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.), and the
  or                                                                                                    authorities for collecting and using your Social Security Number (SSN) are §§428B(f) and
                                                                                                        484(a)(4)(B) of the HEA (20 U.S.C. 1078-2(f) and 1091(a)(4)(B)) and 31 U.S.C. 7701(b).
n Experiencing an economic hardship (including Peace Corps service) as defined by federal
                                                                                                        Participating in the Federal Family Education Loan Program (FFEL) Program and giving us
  law (for up to three years).
                                                                                                        your SSN are voluntary, but you must provide the requested information, including your
If all of the Title IV loans included in my Federal Consolidation Loan were first disbursed on          SSN, to participate.
or after July 1, 2001, a deferment is also available for up to three years while I am serving
                                                                                                        The principal purposes for collecting the information on this form, including your SSN, are
on active duty during a war or other military operation or national emergency, or performing
                                                                                                        to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
qualifying National Guard duty during a war or other military operation or national
                                                                                                        (such as a deferment, forbearance, discharge, or forgiveness) under the FFEL Program,
emergency.
                                                                                                        to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to
My lender will process an in-school deferment based on (i) my request along with                        collect and report on your loan(s) if your loan(s) becomes delinquent or in default. We also
documentation verifying my eligibility, (ii) my lender’s receipt of information from my school          use your SSN as an account identifier and to permit you to access your account information
about my eligibility in connection with a new loan, or (iii) my lender’s receipt of student             electronically.
status information indicating that I am enrolled on at least a half-time basis. For all other
                                                                                                        The information in your file may be disclosed, on a case by case basis or under a computer
deferment types, I must provide my lender with a deferment request and evidence that
                                                                                                        matching program, to third parties as authorized under routine uses in the appropriate
verifies my eligibility.
                                                                                                        systems of records notices. The routine uses of this information include, but are not limited
If I did not consolidate all of my FFELP loans, the deferment options available to me for this          to, its disclosure to federal, state, or local agencies, to private parties such as relatives,
Federal Consolidation Loan will be based on the deferment provisions that are in effect for             present and former employers, business and personal associates, to consumer reporting
any outstanding loan(s) not consolidated, provided the deferment is authorized for Federal              agencies, to financial and educational institutions, and to guaranty agencies in order to
Consolidation Loans. (See Item 4, “Payment of Interest.”) My lender can provide additional              verify your identity, to determine your eligibility to receive a loan or a benefit on a loan,
information about deferment eligibility.                                                                to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s),
                                                                                                        to investigate possible fraud and to verify compliance with federal student financial aid
10. Forbearance – If I am unable to make my scheduled loan payments, the lender may                     program regulations, or to locate you if you become delinquent in your loan payments or
allow me to reduce my payment amount, to extend the time for making payments, or to                     if you default. To provide default rate calculations, disclosures may be made to guaranty
temporarily stop making payments as long as I intend to repay my loan. Allowing me to                   agencies, to financial and educational institutions or to state agencies. To provide financial
temporarily delay or reduce loan payments is called a forbearance. Interest charges continue            aid history information, disclosures may be made to educational institutions. To assist
to accrue during a forbearance period.                                                                  program administrators with tracking refunds and cancellations, disclosures may be
                                                                                                        made to guaranty agencies, to financial and educational institutions, or to federal or state
The lender may grant me forbearance due to poor health or other acceptable reasons.                     agencies. To provide a standardized method for educational institutions efficiently to submit
                                                                                                        student enrollment status, disclosures may be made to guaranty agencies or to financial and
My lender is generally not required to grant a forbearance and may require me to provide                educational institutions. To counsel you in repayment efforts, disclosures may be made to
my reasons for the request and other information.                                                       guaranty agencies, to financial and educational institutions, or to federal, state, or
                                                                                                        local agencies.
The lender may grant me a forbearance to eliminate a delinquency that persists even though
I am making scheduled installment payments. My lender may grant me an administrative                    In the event of litigation, we may send records to the Department of Justice, a court,
forbearance for up to 60 days in order to collect and process documentation supporting my               adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to
request for a deferment, forbearance, change in repayment plan, or consolidation.                       the litigation. If this information, either alone or with other information, indicates a potential
                                                                                                        violation of law, we may send it to the appropriate authority for action. We may send
Circumstances that require my lender to grant me forbearance if I provide appropriate
                                                                                                        information to members of Congress if you ask them to help you with federal student aid
documentation include:
                                                                                                        questions. In circumstances involving employment complaints, grievances, or disciplinary
n Serving in a medical or dental internship or residency program, if I meet certain criteria.           actions, we may disclose relevant records to adjudicate or investigate the issues. If provided
n Serving in a national service position for which I receive a national service education               for by a collective bargaining agreement, we may disclose records to a labor organization
  award under the National and Community Service Trust Act of 1993. In some cases,                      recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for
  the interest that accrues on a qualified loan during the service period will be paid by the           the purpose of performing any programmatic function that requires disclosure of records.
  Corporation for National and Community Service.                                                       Before making any such disclosure, we will require the contractor to maintain Privacy Act
                                                                                                        safeguards. Disclosures may also be made to qualified researchers under Privacy
n Qualifying for partial repayment of my loans under the Student Loan Repayment Program,                Act safeguards.
  as administered by the Department of Defense.
n Having a monthly debt burden for Title IV loans that collectively equals or exceeds                   Financial Privacy Act Notice
  20 percent of my total monthly gross income (for up to three years).                                  Under the Right to Financial Privacy Act of 1978 (12 U.S.C. 3401-3421), the U.S.
n Being called to active duty in the U.S. Armed Forces.                                                 Department of Education will have access to financial records in your student loan file
                                                                                                        maintained by the lender in compliance with the administration of the Federal Family
If I choose not to pay the interest that accrues on my loan during any period of authorized             Education Loan Program.
forbearance, the interest may be capitalized to the extent permitted by the Act. Capitalization
of interest will result in the unpaid interest being added to the principal balance of the loan.        Paperwork Reduction Notice
                                                                                                        According to the Paperwork Reduction Act of 1995, no persons are required to respond
11. Applicability to Aggregate Loan Limits – If the loans I have selected for consolidation             to a collection of information unless it displays a currently valid OMB control number.
were made under the Federal or Direct Stafford (subsidized, nonsubsidized, or                           The valid OMB control number for this information collection is 1845-0036. The time
unsubsidized), SLS, Perkins, or HPSL loan programs, a percentage of the outstanding                     required to complete this information is estimated to average 1.0 hours (60 minutes) per
balance on my Federal Consolidation Loan will be counted towards the aggregate loan limits              response, including the time to review instructions, search existing data resources, gather
for each type of loan selected.                                                                         and maintain the data needed, and complete and review the information collection. If you
                                                                                                        have any comments concerning the accuracy of the time estimate(s) or suggestions for
12. Adding Loans – If I do not consolidate all eligible loans at this time, I understand that I
                                                                                                        improving this form, please write to:
may later add to this Federal Consolidation Loan an eligible loan(s) made before or after the
date of this consolidation by submitting a request to my lender. My lender must receive my              U.S. Department of Education
request within 180 days after the date on which my Federal Consolidation Loan is disbursed.             Washington, DC 20202-4651
After the 180-day period, no loan can be added to this Federal Consolidation Loan and I will
need to apply for a new Federal Consolidation Loan to consolidate any eligible loan(s).                 If you have any comments or concerns regarding the status of your individual
                                                                                                        submission of this form, contact the lender, guarantor, or program identified in the
                                                                                                        upper right-hand corner of this form.



                                                                                                Page 8 of 8
Federal Family Education Loan Program (FFELP)
                                                                                                                           Guarantor, Program, or Lender Identification                                         OMB No. 1845-0036
                                                                                                                                                                                                                Form approved

Federal Consolidation Loan                                                                                                                                                                                      Exp. date 01/31/2010


Application and Promissory Note
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any
accompanying documents is subject to penalties that may include fines, imprisonment, or both, under the
U.S. Criminal Code and 20 U.S.C. 1097.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW LOAN ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain,
verify, and record information that identifies each person who opens a loan account. What this means for you: Your name, address, date of birth, and other information collected in this form will be used to verify your identity. You may
also be asked to provide your driver’s license or other identifying documents.

Before You Begin
Read the Instructions for Completing the Federal Consolidation Loan Application and Promissory Note. Print using dark ink ballpoint pen or type. This form must be signed and dated by
the applicant.                        **PAGES 1, 2, AND 3 OF THIS FORM MUST BE SUBMITTED FOR YOUR APPLICATION TO BE PROCESSED.**
Section A. Borrower Information
 1. Last Name                                                                    First Name                                                        MI                 2. Social Security Number


3A. Permanent Address (Include Number, Street, Apartment Number; or Rural Route Number and Box Number, as applicable) City, State, Zip Code


3B. Permanent Mailing Address, if different from 3A. (Include P.O. Box or General Delivery, as applicable) City, State, Zip Code


 4. Area Code/Telephone Number                                                                                          5. Former Name(s)
    (        )
 6. Date of Birth (mm-dd-yyyy)                                                                                          7. Driver’s License State and Number
                                                                                                                           State                   #
 8. E-mail Address


 9. Employer Name


     Address


     City                                                                        State                          Zip Code                                                 Work Area Code/Telephone Number
                                                                                                                                                                         (        )
10. Consolidating Lender Name                                                                                                                                         11. Lender Code, if known


Section B. Reference Information
References: You must provide two separate references with different addresses who have known you for at least three years. Both references must be completed in full. Do not include
individuals who live with you (e.g., your spouse) or who live outside the United States.


12. Name                                     A.                                                                                               B.


    Permanent Address


    City, State, Zip Code


    E-mail Address (optional)


    Area Code/Telephone Number                    (            )                                                                                    (             )


    Relationship to Borrower

Section C. Promissory Note (To be completed and signed by the borrower.)
(In this Promissory Note, “lender” refers to, and this Promissory Note benefits, the original consolidating lender and its successors and assigns, including any subsequent holder of this
Promissory Note.)
13. Promise to Pay:
I promise to pay to the order of the lender all sums disbursed (hereafter “loan”) under the terms of this Promissory Note (hereafter “Note”) to pay off my prior loan obligations, plus
interest and other charges and fees that may become due as provided in this Note. Unless I make interest payments, interest that accrues on my loan during forbearance periods and
on the unsubsidized portion of my loan during deferment periods may be added, as provided under the Act, to the principal balance of my loan. If I do not make any payment on this Note
when it is due, I will also pay reasonable collection costs, including but not limited to attorney’s fees, court costs, and other fees.
I will not sign this Note before reading the entire Note, even if I am told not to read it, or told that I am not required to read it. I am entitled to an exact copy of this Note and the Borrower’s
Rights and Responsibilities Statement. My signature certifies I have read, understand, and agree to the terms and conditions of this Note, including the Borrower Certification and
Authorizations and the Borrower’s Rights and Responsibilities Statement.

I UNDERSTAND THAT THIS IS A LOAN THAT I MUST REPAY.

14. Borrower’s Signature                                                                                                                                                Today’s Date (mm-dd-yyyy)


                                                                                                       Submit pages 1, 2, and 3
                                                                                                             Page 1 of 8
Borrower Name                                                                                               Social Security Number
Please print.

Section D.1. Education Loan Indebtedness — Loans You Want to Consolidate
Read the instructions before completing this section. List each federal education loan you want to consolidate, including each loan (if any) currently held by the lender that will be
consolidating your loans. Use the Loan Codes listed in the instructions. The loan holder/servicer is the entity to which you send your payments. If you need to list additional loans, use the
Additional Loan Listing Sheet included in this package. (If an Additional Loan Listing Sheet is not included, you may obtain one from your consolidating lender.) List each loan separately.
Please print. ONLY LIST LOANS THAT YOU WANT TO CONSOLIDATE IN THIS SECTION.

15. Loan Code        16. Loan Holder/Servicer Name and Mailing Address                                       17. Loan Account Number             18. Interest Rate 19. Estimated Payoff Amount
(See Instructions)   (See Instructions)




20. Grace Period End Date – If any of the loans that you have selected for consolidation are in a grace period, you can delay
the processing of your Federal Consolidation Loan until the end of your grace period by entering your expected grace period end                 (month/year)
date in the space provided. If you leave this field blank, your Federal Consolidation Loan will be processed and any selected loans
that are in a grace period will enter repayment immediately upon consolidation.

Section D.2. Education Loan Indebtedness — Loans You Do Not Want to Consolidate
Read the instructions before completing this section. List each education loan that you are not consolidating but want considered in calculating your maximum repayment period.
Remember to include each loan (if any) held by the lender that will be consolidating your loans, but that you do not want to include in your Federal Consolidation Loan. Use the Loan Codes
listed in the instructions. The loan holder/servicer is the entity to which you send your payments. If you need to list additional loans, use the Additional Loan Listing Sheet included in this
package. (If an Additional Loan Listing Sheet is not included, you may obtain one from your consolidating lender.) List each loan separately. Please print. ONLY LIST LOANS THAT YOU DO
NOT WANT TO CONSOLIDATE IN THIS SECTION.
21. Loan Code        22. Loan Holder/Servicer Name and Mailing Address                                       23. Loan Account Number             24. Interest Rate 25. Current Balance
(See Instructions)   (See Instructions)




                                                                                    Submit pages 1, 2, and 3
                                                                                          Page 2 of 8
Borrower Name                                                                                             Social Security Number
Please print.

Section E. Repayment Plan Selection




26.


Section F. Borrower Certification and Authorizations
27. Under penalty of perjury, I certify that:                                                      unpaid accrued interest, and other costs as permitted by federal regulations in the
A. The information I have provided on this Federal Consolidation Loan Application                  payoffs reported to the consolidating lender. I understand that if any collection
   and Promissory Note and as updated by me from time to time is true, complete,                   costs are owed on the loans selected for consolidation, these costs may be
   and correct to the best of my knowledge and belief and is made in good faith.                   added to the principal balance of the Federal Consolidation Loan and, in the case
                                                                                                   of Federal Stafford, SLS, PLUS, or Consolidation loans in default and held by a
B. I do not have any other application pending for a Federal Consolidation Loan.                   guaranty agency, may not exceed 18.5 percent of the outstanding principal and
C. All of the loans selected for consolidation have been used to finance my education              interest on the loan at the time the holders certify the payoff amounts.
   or the education of my dependent student(s).                                                 B. I understand that I may no longer be eligible for some deferments and for subsidized
D. All of the loans selected for consolidation are in a grace period or in repayment               deferment periods on some loans being consolidated. I also understand that I may
   (including loans in deferment or forbearance).                                                  no longer be eligible for some loan discharges and types of forgiveness that were
E. If I have an outstanding Federal Consolidation Loan, I am eligible for another                  available on the loans being consolidated.
   Federal Consolidation Loan because: (i) I have another eligible loan(s), or (ii) I am        C. I authorize the consolidating lender to contact the holders identified on my
   consolidating a Federal Consolidation Loan with at least one other eligible loan.               application to determine the eligibility and/or payoff amounts for the loans I have
                                                                                                   selected for consolidation. I further authorize those holders to release
F. If I owe an overpayment on a Federal Perkins Loan, Federal Pell Grant, Federal                  that information.
   Supplemental Educational Opportunity Grant, Academic Competitiveness Grant
   (ACG), National Science or Mathematics Access to Retain Talent (SMART) Grant,                D. I authorize the consolidating lender to send the proceeds of my Federal Consolidation
   or Leveraging Educational Assistance Partnership Grant, I have made satisfactory                Loan to each holder of the loans I have identified to pay off the debts.
   arrangements with the holder to repay the amount owed.                                       E. If the amounts my consolidating lender sends to my holders exceed the amounts
G. I am not now in default on any loan that I am consolidating, or, if I am in default,            needed to pay off the balances of the selected loans, I understand that the holders
   I have either (a) made satisfactory arrangements with the holder of the defaulted               will refund the excess to my consolidating lender to be applied against the
   loan(s) to repay the amount owed, or (b) for Federal Stafford, SLS, PLUS, or                    outstanding balance of this loan. If the amounts my consolidating lender sends to
   Consolidation loans, I agree to repay the Federal Consolidation Loan under                      my holders are less than the amounts needed to pay off the balances of the loans
   income-sensitive repayment terms.                                                               selected for consolidation, I will be responsible for notifying my consolidating lender
                                                                                                   about the remaining amounts. I authorize the consolidating lender to include the
H. If I have been convicted of, or pled nolo contendere (no contest) or guilty to, a               remaining amounts in this Federal Consolidation Loan, unless I pay off the remaining
   crime involving fraud in obtaining federal student assistance under Title IV of the             balances.
   Higher Education Act of 1965, as amended, I have completed the repayment of
   those funds to the U.S. Department of Education (the Department), or to the loan             F. I authorize the consolidating lender, the guarantor, or their agents to investigate
   holder in the case of a Title IV federal student loan.                                          my credit record and report information concerning my loan status to persons and
                                                                                                   organizations permitted by law to receive such information.
I. I am not subject to a judgment secured through litigation or to an order for wage
     garnishment, except as I have disclosed.                                                   G. I authorize the release of information pertinent to my loan: (i) by the school(s),
                                                                                                   the lender, and the guarantor, or their agents, to the references on this loan and to
                                                                                                   members of my immediate family unless I submit written directions otherwise; and
28. I make the following authorizations and statements of understanding:                           (ii) by and among my schools, lenders, guarantors, the Department, and their agents.
A. I understand that the amount of my Federal Consolidation Loan will be based                  H. If I have HEAL loans serviced by the consolidating lender and such loans are not
    on the payoff amounts of my outstanding eligible loans that I selected for                     included in this Federal Consolidation Loan, I authorize the establishment of a
    consolidation, as provided by the holders of those loans, and may exceed my                    combined payment plan on my behalf.
    estimate of such payoff amounts. The actual payoff amounts may differ from
    the estimated payoff amounts because the holders will include unpaid principal,

                         Review your Federal Consolidation Application and Promissory Note to ensure you completed all sections, including Section E above.




                                                                                   Submit pages 1, 2, and 3
                                                                                         Page 3 of 8
Federal Consolidation Loan Application and Promissory Note (continued)
Disclosure of Terms                                                                                   Repayment
This Note applies to Federal Consolidation Loans made under the Federal Family Education              I must repay the full amount of the loan made under this Note and the accrued interest.
Loan Program. In this Note, the Higher Education Act of 1965, as amended (20 U.S.C. 1070              Repayment begins upon disbursement of the loan, and my first payment will be due within
et seq.), and applicable U.S. Department of Education regulations are collectively referred           60 days after the disbursement.
to as the “Act.” In this Note, references to “the Department” mean the U.S. Department of
                                                                                                      Payments will be scheduled in monthly installments according to the disclosure my lender
Education.
                                                                                                      will provide to me. The disclosure will state my payment amounts and due dates. The
At or about the time my Federal Consolidation Loan is disbursed, a disclosure statement               maximum scheduled repayment period may be up to 30 years in length, depending upon
and repayment schedule (“disclosure”) will be provided to me. This disclosure will identify           the amount of my student loans and my repayment plan. The minimum payment on my
my Federal Consolidation Loan amount and additional terms of the loan. If I have questions            loan must equal at least the amount of interest that accrues between scheduled payments.
about the information disclosed, I will contact the lender. If the information in this Note
                                                                                                      Payments submitted by me or on my behalf (exclusive of refunds) may be applied first to
conflicts with information in the disclosure, the specific terms and information in the
                                                                                                      late charges and collection costs that are due, then to accrued interest that has not been
disclosure apply to my loan.
                                                                                                      capitalized, and finally to the principal amount. If I am unable to make my scheduled loan
Important additional terms of this loan are disclosed in the Borrower’s Rights and                    payments, the lender may allow me to reduce my payment amount, extend the time for
Responsibilities Statement accompanying this Note.                                                    making payments, or temporarily stop making payments as long as I intend to repay my
                                                                                                      loan. Allowing me to temporarily delay or reduce my loan payment is called forbearance.
I agree that the lender may sell or assign my loan to another eligible holder.
                                                                                                      The lender may grant me a forbearance to align payment due dates on my loans or to
Interest                                                                                              eliminate a delinquency that persists even though I am making scheduled payments.
Unless my lender notifies me in writing of a lower rate(s), the rate(s) of interest for my loan       I may prepay all or any part of the unpaid balance on my loan at any time without penalty.
is that specified in the Act. Interest rate information is presented in the Borrower’s Rights         Upon payment in full of this Note, I agree to accept written notification of the payoff in
and Responsibilities Statement accompanying this Note. The interest rate is presented in a            place of receiving the original Note.
disclosure that is provided to me.
                                                                                                      Acceleration and Default
Interest accrues on the unpaid principal balance of my Federal Consolidation Loan from the
                                                                                                      At the option of the lender, the entire unpaid balance will become immediately due and
date of disbursement by the lender until the entire principal balance is paid in full.
                                                                                                      payable when either of the following events occurs: (i) I make a false representation that
This includes interest accruing during any period of deferment or forbearance. I agree to
                                                                                                      results in my receiving a loan for which I am not eligible; or (ii) I default on the loan.
pay all interest charges on my loan except for interest payable by the federal government
under the Act.                                                                                        The following events shall constitute a default on my loan: (i) I fail to pay the entire unpaid
                                                                                                      balance after the lender has exercised its option under item (i) in the preceding paragraph,
I will be responsible for the interest that begins accruing upon disbursement of my loan.
                                                                                                      (ii) I fail to make installment payments when due and my failure persists for at least 270
If I do not make payments of interest before the beginning of principal repayment, or
                                                                                                      days, or (iii) I fail to comply with other terms of the loan, and the lender or guarantor
during a period of authorized deferment or forbearance, I agree that the lender may
                                                                                                      reasonably concludes I no longer intend to honor my repayment obligation. If I default, the
capitalize such interest to the extent permitted by the Act.
                                                                                                      guarantor may purchase my loan and capitalize all outstanding interest into a new principal
Except for any portion of the Federal Consolidation Loan attributable to a HEAL Loan, this            balance. The new principal balance and collection fees will become immediately due
loan will bear simple interest at an annual rate that is fixed for the term of the loan. The          and payable.
maximum interest rate on this loan will be equal to the weighted average of the interest
                                                                                                      If I default, the default will be reported to all national credit bureaus and will significantly
rates (as certified by the holder) on the loans being consolidated, rounded up to the nearest
                                                                                                      and adversely affect my credit history. I acknowledge that a default will have additional
higher one-eighth of one percent, not to exceed 8.25 percent.
                                                                                                      adverse consequences to me as disclosed in the Borrower’s Rights and Responsibilities
If I choose to consolidate a fixed rate Federal ALAS/SLS Loan(s) or Federal PLUS Loan(s),             Statement. Following default, the loan may be subject to income-contingent repayment
I request that the existing interest rate of each loan be converted before consolidation to           (including potential collection of amounts in excess of the principal and interest) in
the refinancing rate provided for in the Act, if that rate is lower than the existing rate. If my     accordance with the Act.
lender grants this request, I understand there will be no separate document evidencing
                                                                                                      Governing Law and Notices
this refinancing.
                                                                                                      The terms of this Note will be interpreted according to the Act, other applicable federal
For the portion of the Federal Consolidation Loan attributable to a HEAL loan (if applicable),
                                                                                                      statutes and regulations, and the guarantor’s policies. Applicable state law, except as
the interest rate is a variable rate and is adjusted annually on July 1. The variable rate for
                                                                                                      preempted by federal law, may provide for certain borrower rights, remedies, and defenses
each 12-month period will be equal to the average of the bond equivalent rates of the
                                                                                                      in addition to those stated in this Note.
91-day Treasury Bills auctioned for the quarter ending June 30, plus 3.0 percent; there is
no maximum interest rate on this portion of the loan.                                                 If I reside in the state where the guarantor’s principal office is located, the guarantor may
                                                                                                      sue to enforce the loan in the county where the guarantor’s office is located. However, if I
180-Day Add-On Provision
                                                                                                      object to being sued there and I mail a written objection to the guarantor that is postmarked
If I do not consolidate all eligible loans at this time, I understand that I may later add to         no later than 30 days after I am served with the lawsuit, the guarantor will either have the
this Federal Consolidation Loan an eligible loan(s) made before or after the date of this             court transfer the lawsuit to the county where I live or will dismiss the lawsuit.
consolidation. To add an eligible loan(s), I understand I must complete a Request to Add
                                                                                                      Any notice required to be given to me will be effective if sent by first class mail to the latest
Loans form which is available from the lender and which must be received by the lender
                                                                                                      address the lender has for me or by electronic means to an address that I have provided.
within 180 days after the date this Federal Consolidation Loan is disbursed. If I add a
                                                                                                      I will immediately notify the lender of any change of address or status as specified in the
loan during this period, the lender will disclose new terms to me. The new terms and
                                                                                                      Borrower’s Rights and Responsibilities Statement. Failure by the lender to enforce or
information will supersede the terms and information in any prior disclosure. After the
                                                                                                      insist on compliance with any term of this Note shall not waive any right of the lender.
180-day period, no loan can be added to this Federal Consolidation Loan and I will need to
                                                                                                      No provision of this Note may be modified or waived except in writing by the lender of
apply for a new Federal Consolidation Loan to consolidate any eligible loan(s).
                                                                                                      the Note. If any provision of this Note is determined to be unenforceable, the remaining
Late Charges and Collection Costs                                                                     provisions remain in force.
The lender may collect from me: (i) a late charge for each late installment payment if I fail
to make any part of a required installment payment within 15 days after it becomes due,
and (ii) any other charges and fees that are permitted by the Act for the collection of my
loans. If I default on the loan, I will pay reasonable collection fees and costs, plus court
costs and attorney’s fees.




                                                                                               Page 4 of 8
 Federal Family Education Loan Program (FFELP)
                                                                                                  Guarantor, Program, or Lender Identification


 Instructions for Completing the Federal Consolidation Loan Application
 and Promissory Note

 Before You Begin                                                                                    Section D. Education Loan Indebtedness

Before beginning, gather all of your education loan records, account statements, and                Education Loans
bills so that you have the information you need to complete the Federal Consolidation
Loan Application and Promissory Note.                                                               The following types of education loans (except those represented by the code OTHER)
                                                                                                    are eligible for consolidation:
Print using a dark ink ballpoint pen or type. Enter dates as month-day-year
(mm-dd-yyyy). Use only numbers. Example: June 24, 1982 = 06-24-1982. This form                      Loan Code             Education Loans
must be signed and dated by the applicant. If an item has been completed for you and                SS        Subsidized Federal Stafford Loans
it is incorrect, cross out the incorrect information and print the correct information.             DSS       Direct Subsidized Stafford/Ford Loans
Incorrect or incomplete information may delay processing of your application.                       US        Unsubsidized and Nonsubsidized Federal Stafford Loans
                                                                                                    DUS       Direct Unsubsidized Stafford/Ford Loans
If you have any questions about completing this application, contact the entity                     PLUS      Federal PLUS Loans (for parents)
identified above.                                                                                   GB        Federal PLUS Loans (for graduate/professional students)
                                                                                                    DPLUS     Direct PLUS Loans (for parents)
 Section A. Borrower Information                                                                    D3        Direct PLUS Loans (for graduate/professional students)
                                                                                                    SLS       Federal Supplemental Loans for Students
Item 1: Enter or correct your last name, first name, and middle initial.                            PERK      Federal Perkins Loans and National Direct Student Loans
Item 2: Enter or correct your Social Security Number.                                               SCON      Subsidized Federal Consolidation Loans
                                                                                                    DSCON     Direct Subsidized Consolidation Loans
Item 3: Enter your permanent address (number, street, apartment number, or rural
                                                                                                    UCON      Unsubsidized Federal Consolidation Loans
route number and box number, then city, state, zip code). If your mailing address
                                                                                                    DUCON     Direct Unsubsidized Consolidation Loans, including Direct PLUS
is a post office box or general delivery, you must list your mailing address in 3B, in
                                                                                                              Consolidation Loans
addition to your home address in 3A.
                                                                                                    HPSL      Health Professions Student Loans, including Loans for
Item 4: Enter the area code and telephone number at which you can most easily be                              Disadvantaged Students
reached. (Do not list your work telephone number here.) If you do not have a tele-                  HEAL      Health Education Assistance Loans
phone, enter N/A.                                                                                   FISL      Federal Insured Student Loans
Item 5: Enter any former names under which one or more of your loans may have                       NSL       Federal Nursing Loans
been disbursed. If you do not have a former name, enter N/A.                                        OTHER     Other education loans not eligible for consolidation that you want used to
                                                                                                              calculate the maximum repayment period
Item 6: Enter the date of your birth. Be careful not to enter the current year.
Item 7: Enter the two-letter abbreviation for the state that issued your driver’s license           Information you need to answer items in this section is available in loan documents,
followed by the driver’s license number. If you do not have a driver’s license,                     such as:
enter N/A.                                                                                          n The last monthly billing statement you received,
Item 8: Enter your preferred e-mail address for receiving communications. You are                   n Your quarterly interest statement or annual statement,
not required to provide this information. If you do, the lender or holder of your loan              n Your coupon book, or
may use your e-mail address to communicate with you. If you do not have an e-mail
address, or do not wish to provide it, enter N/A.                                                   n The Internet site of your loan holder or servicer.

Item 9: It is important that the consolidating lender is able to reach you during the               If you are unsure of the correct information on your loans, contact the entity to which
process of making your loan and during repayment. Enter your employer’s name,                       you send your payments or check the most recent correspondence from that entity.
address (including number, street, suite number, city, state, and zip code), and your               You may also obtain information on your loan(s) by accessing the National Student
work telephone number (or the number of your work cellular telephone or other                       Loan Data System at http://www.nslds.ed.gov.
wireless device). If you are self-employed, enter the name, address, and telephone
number of your business (or the number of your business cellular telephone or other                 Step 1: Begin by listing (according to the instructions that follow for Items 15-19)
wireless device). If you are not employed, enter N/A.                                               eligible loan(s) that you wish to consolidate, including any loan(s) currently held by the
                                                                                                    lender that will be consolidating your loan(s). You may consolidate a Federal Consolidation
Item 10: Enter the name of the lender you would like to finance your Federal                        Loan only if you are combining that loan with at least one other eligible loan.
Consolidation Loan.
                                                                                                    If you are in default on any loan that you wish to consolidate, you must have made
Item 11: Enter the lender code, if known. Otherwise, leave this item blank.                         satisfactory repayment arrangements with the holder to repay the loan before it is
                                                                                                    eligible for consolidation. Satisfactory arrangements usually involve making a series
 Section B. Reference Information                                                                   of payments on the defaulted loan. For Federal Stafford, Federal SLS, Federal PLUS,
                                                                                                    or Federal Consolidation loans, satisfactory repayment arrangements involve making
Items 12A and 12B: Enter the requested reference information for two adults with                    a series of reasonable and affordable payments or agreeing to repay the new Federal
different addresses who have known you for at least three years. References with                    Consolidation Loan under an income-sensitive repayment plan. Contact the holder of
addresses outside the United States are not acceptable. Do not include individuals                  your defaulted loan for specific information.
who live with you. If a reference does not have a telephone number or e-mail address
or does not wish to provide an e-mail address, enter N/A. If you provide an e-mail                  Item 15: Enter the code that corresponds to the loan type from the Education Loans
address for a reference, the lender or holder of your loan may use it to communicate                list. If you are not sure about the loan type, leave this item blank.
with the reference. All requested items must be completed or processing of your                     Item 16: Enter the full name and mailing address of the holder of each of your federal
application will be delayed.                                                                        education loans or the holder’s servicer. (This is the address to which you are or will
                                                                                                    be sending your payments.) Do not use initials instead of full names. For a defaulted
 Section C. Promissory Note                                                                         FFELP loan, the holder is the guaranty agency or the Department of Education. For a
                                                                                                    defaulted Federal Direct Loan, the holder is the Department of Education. For a Perkins
This is a legally binding contract.                                                                 Loan, the holder is the school.
Item 13: Carefully read the entire Promissory Note, Borrower Certification and                      Item 17: Enter the account number for each loan. This may be listed on your
Authorization, Borrower’s Rights and Responsibilities Statement, and the other                      monthly billing statement or coupon or in other information your holder or
materials provided in connection with this loan.                                                    holder’s servicer provides.
Item 14: Sign and date the Promissory Note.                                                         Item 18: Enter the interest rate you are paying on each loan.
Note: Signature is required. If you fail to sign the Promissory Note, your application              Item 19: Enter the estimated payoff amount, including any unpaid interest, late fees,
will be delayed.                                                                                    and collection costs.
                                                                                                                                                                        Continued on next page.

                                                                                            Page 5 of 8
Item 20: If you are in your grace period (the specified period of time after a student        Section F. Borrower Certification and Authorization
graduates, leaves school, or drops to less than half-time enrollment during which
loan payments are not required and during which interest on loans may be payable             Items 27 and 28: Read these items carefully. The statements confirm the accuracy
by the federal government) for any of the loans selected for consolidation and you           of information that you supply, authorize various parties to perform certain functions,
wish to delay processing until you have completed your grace period, enter the month         and certify your understanding and acceptance of certain terms and conditions of
and year that your grace period ends. If you request such a delay, processing of your        the loan.
Federal Consolidation Loan will begin approximately 60-90 days before the latest
grace period end date. If you leave this field blank, the processing of your Federal          Submitting Your Application and Promissory Note
Consolidation Loan will not be delayed and any selected loans that are in a grace
period will enter repayment immediately upon consolidation.                                  Review all information on your Federal Consolidation Loan Application and Promissory
                                                                                             Note. Return pages 1 through 3 of your completed application and promissory note to
Step 2: The maximum length of your Federal Consolidation Loan repayment period is            your consolidating lender for processing. Keep a copy for your records. Remember
determined by your total education loan debt, including:                                     to continue making your regularly scheduled education loan payments until your
n Loans you are consolidating,                                                               consolidating lender notifies you that the consolidation is complete. If you would
                                                                                             like to temporarily postpone your payments while your Federal Consolidation Loan
n Loans eligible for consolidation that you are not consolidating, and                       is being processed, contact your holder(s) regarding forbearance. When your loans
n Loans not eligible for consolidation.                                                      are consolidated, you will receive a repayment schedule and disclosure statement for
                                                                                             your Federal Consolidation Loan. It will provide information about your new loan and
In Items 21-25, list eligible loans you do not wish to consolidate and outstanding
                                                                                             instructions on where to send your monthly payments.
education loans not eligible for consolidation that you want used to determine
your maximum repayment period. Outstanding education loans not eligible for
                                                                                             Mailing Instructions: Mail the original copy of the Federal Consolidation Loan
consolidation must have been made exclusively to finance postsecondary education
                                                                                             Application and Promissory Note and the Additional Loan Listing Sheet, if applicable,
by an entity such as a bank, school, or state agency under a public or private loan
                                                                                             to your consolidating lender.
program. Personal loans from family or friends or loans in default may not be listed.
The amount of the loans that are not included in the Federal Consolidation Loan but
are used to determine your repayment period will not exceed the amount of the loans
consolidated.

 Section E. Repayment Plan Selection

Item 26:




Note: You may apply for a Federal Consolidation Loan from any FFELP lender.
Alternatively, if you are eligible for a FFELP consolidation loan and you are unable to
obtain a Federal Consolidation Loan or a Federal Consolidation Loan with income-
sensitive repayment terms that are acceptable to you, you may apply for a Federal
Direct Consolidation Loan from the U.S. Department of Education. In addition, if
you have a Federal Consolidation Loan that has become seriously delinquent or
that has defaulted, you may be eligible to consolidate that loan into a Federal Direct
Consolidation Loan for the purpose of obtaining an income-contingent repayment plan.

                                                                                     Page 6 of 8
Borrower’s Rights and Responsibilities Statement
Important Notice: The Borrower’s Rights and Responsibilities Statement provides additional information about the terms and conditions of your Federal Consolidation Loan.
Please retain this Statement for your records. You may contact your lender at any time for another copy of this Statement.

The Federal Family Education Loan Program (FFELP) includes the following loans:                     n An increase in my interest rate,
n Subsidized Federal Stafford Loan,                                                                 n Loss of eligibility for other student aid and assistance under most federal benefit
n Unsubsidized Federal Stafford Loan,                                                                 programs,

n Federal Insured Student Loan (FISL),                                                              n Loss of eligibility for loan deferments, and

n Federal Supplemental Loans for Students (SLS),                                                    n Negative credit reports to credit bureaus.

n Federal PLUS Loan, and                                                                            NOTE: To avoid the consequences of default, I may be eligible to consolidate a Federal
                                                                                                    Consolidation Loan that has become seriously delinquent or that has defaulted through the
n Federal Consolidation Loan.
                                                                                                    U.S. Department of Education’s Federal Direct Consolidation Loan Program for the purpose
The FFELP is authorized by Title IV, Part B of the Higher Education Act of 1965 as amended.         of obtaining an income-contingent repayment plan.

1. Governing Law – A loan disbursed under this Federal Consolidation Loan Promissory                7. Credit Bureau Notification – Information concerning the amount, disbursement, and
Note (Note) is subject to the Higher Education Act of 1965, as amended (20 U.S.C. 1070 et           repayment status (current or delinquent) of my loan will be reported by my lender to one
seq.), and applicable U.S. Department of Education regulations (collectively referred to as         or more national credit bureaus on a regular basis. If I default on my loan, the default
the “Act”).                                                                                         will also be reported by the guarantor to all national credit bureaus. Before the guarantor
                                                                                                    reports such a default, it will give me at least 30 days notice that default information will
2. Change of Status – I must notify my lender or any subsequent holder of my loan if any of         be disclosed to the credit bureaus unless I enter into a repayment arrangement within 30
the following events occurs:                                                                        days of the date of the notice. The guarantor will give me a chance to ask for a review of the
n I change my address, e-mail address, or telephone number,                                         debt before the default is reported. My lender or guarantor, as applicable, must provide a
                                                                                                    timely response to a request from any credit organization regarding objections I might raise
n I change my name (for example, maiden name to married name),
                                                                                                    with that organization about the accuracy and completeness of information reported by the
n I change my employer or my employer’s address or telephone number changes, or                     lender or guarantor.
n I have any other change in status that would affect my loan (for example, the loss of             8. Loan Discharge & Forgiveness – My loan will be discharged if documentation of my
   eligibility for an unemployment deferment by obtaining a job).                                   death is submitted to my lender. If I am consolidating a PLUS Loan and the dependent
3. Interest Rate – The interest rate on a Federal Consolidation Loan is based on the                student for whom I borrowed the PLUS Loan dies, the portion of my Federal Consolidation
weighted average of the interest rates on the loans being consolidated rounded up to the            Loan attributable to that PLUS Loan will be discharged if documentation of the dependent
nearest higher one-eighth of one percent, not to exceed 8.25%. This fixed interest rate             student’s death is submitted to my lender.
remains the same throughout the life of the loan. For the portion of a Federal Consolidation        My loan may also be discharged if a physician certifies that I am totally and permanently
Loan attributable to a HEAL loan, the interest rate is a variable rate, adjusted annually on        disabled as defined by the Act. In addition, I must meet certain employment earnings
July 1. The variable rate is equal to the average of the bond equivalent rates of the 91-day        requirements and may not receive any additional FFELP, Direct, or Federal Perkins loans
Treasury Bills auctioned for the quarter ending June 30, plus 3.0%; there is no maximum             during a 3-year conditional discharge period. I may not receive a discharge due to total
interest rate on this portion of the loan. The interest rate of my Federal Consolidation Loan       and permanent disability based on a condition that existed before the loans that are being
will be disclosed to me at or about the time my loan is disbursed.                                  consolidated were made, unless a physician certifies that the condition substantially
4. Payment of Interest – It is my responsibility to pay interest on the unpaid principal            deteriorated after the loans that are being consolidated were made.
amount of my loan. Interest will be charged from the date my Federal Consolidation Loan             I understand that I may not qualify for a disability discharge of my Federal Consolidation
is disbursed. The federal government will pay interest that accrues during deferment on             Loan if any loan I am consolidating does not meet the discharge conditions.
the portion of my Federal Consolidation Loan that repays subsidized Federal Stafford
Loans, subsidized Federal Direct Stafford Loans, subsidized FISL loans, subsidized                  My loan will not be automatically discharged in bankruptcy. To discharge a loan in
Federal Consolidation Loans, and subsidized Federal Direct Consolidation Loans. I will              bankruptcy, I must prove undue hardship in an adversary proceeding before the
be responsible for interest that accrues during deferment on the portion of my Federal              bankruptcy court.
Consolidation Loan that repays other loan types.
I am responsible for paying the interest that accrues during a forbearance period.                  In certain cases, the Act provides for discharge of all or a portion of my Federal
                                                                                                    Consolidation Loan if:
If I inform my lender that I wish to pay interest as it accrues, but I do not make any
payments, my lender may capitalize that interest. Capitalized interest increases the principal      n One or more FFELP, Direct, or Federal Perkins loans that I consolidated were used to pay
balance of my loan and the total amount of interest charges I must pay.                               for a course of study that I was unable to complete because my school closed, or
                                                                                                    n My eligibility for one or more FFELP or Direct loans that were consolidated was (i) falsely
Interest on my loan may be capitalized to the extent permitted by the Act. Generally,                 certified by my school or (ii) falsely certified as a result of a crime of identity theft.
capitalization may occur no more frequently than quarterly.
                                                                                                    The Act also provides for discharge in the amount of any required refund of a FFELP or
I may be able to claim a federal income tax deduction for interest payments I make on my            Direct loan that my school failed to make to my loan holder on my behalf.
FFELP loans. For further information, I may refer to the IRS Publication 970 available at
http://www.irs.gov.                                                                                 Neither the lender, the guarantor, nor the Department of Education vouch for the quality or
                                                                                                    suitability of the academic programs offered by participating schools. Unless I qualify for
5. Sale or Transfer of Loan – The lender may sell or otherwise transfer my loan without             loan discharge under the Act, I must repay this loan even if I do not complete my education,
my consent. Should ownership of my loan be transferred, I will be notified of the name,             I am unable to obtain employment in my field of study, or I am dissatisfied with, or do not
address, and telephone number of the new lender if the address to which I must make                 receive, the education I paid for with the loan(s) being consolidated.
payments changes. Sale or transfer of my loan does not affect my rights and responsibilities
under the loan.                                                                                     If I am a full-time teacher and at the time I obtained a subsidized or unsubsidized Stafford
                                                                                                    Loan that I am consolidating I had no outstanding balance on a Title IV loan disbursed
6. Consequences of Default – Default is defined in detail in my Note. If I default, the entire      before October 1, 1998, I may be eligible for forgiveness under the Teacher Loan
unpaid balance and collection fees will become immediately due and payable. Failure to repay        Forgiveness Program. A fixed amount of my Stafford loan(s) that I am consolidating may
this loan according to its terms and conditions may result in any or all of the following:          be repaid if I have worked as a full-time teacher for five consecutive school years and if I
n Loss of federal and state income tax refunds,                                                     meet all other eligibility requirements under the Act.

n Loss of other federal or state payments,                                                          I understand that, by consolidating, I may forego some discharges that might otherwise be
                                                                                                    available for the loan(s) being consolidated.
n My employer withholding part of my wages to give them to my guarantor (administrative
  wage garnishment),                                                                                9. Deferment – Under certain circumstances, I have a right to defer (postpone) repayment.
n Legal action against me,                                                                          Upon request, my lender will provide me with a deferment application that explains the
                                                                                                    eligibility requirements. If I am in default on my Federal Consolidation Loan, I am not eligible
n Collection charges (including attorney’s fees) being assessed against me,
                                                                                                    for deferment unless I make payment arrangements satisfactory to my lender before the
n Loss of my professional license,                                                                  payment of a default claim on the loan.

                                                                                            Page 7 of 8
If I consolidate all of my eligible FFELP loans, deferments are available while I am:                   IMPORTANT NOTICES
n Enrolled at least half time at an eligible school,                                                    Privacy Act Notice
n Engaged in a full-time course of study in a graduate fellowship program,                              The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided
n Engaged in a full-time rehabilitation training program for individuals with disabilities              to you:
  (if the program is approved by the Department of Education),
                                                                                                        The authority for collecting the requested information from and about you is §421 et seq.
n Conscientiously seeking, but unable to find, full-time employment (for up to three years),            of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.), and the
  or                                                                                                    authorities for collecting and using your Social Security Number (SSN) are §§428B(f) and
                                                                                                        484(a)(4)(B) of the HEA (20 U.S.C. 1078-2(f) and 1091(a)(4)(B)) and 31 U.S.C. 7701(b).
n Experiencing an economic hardship (including Peace Corps service) as defined by federal
                                                                                                        Participating in the Federal Family Education Loan Program (FFEL) Program and giving us
  law (for up to three years).
                                                                                                        your SSN are voluntary, but you must provide the requested information, including your
If all of the Title IV loans included in my Federal Consolidation Loan were first disbursed on          SSN, to participate.
or after July 1, 2001, a deferment is also available for up to three years while I am serving
                                                                                                        The principal purposes for collecting the information on this form, including your SSN, are
on active duty during a war or other military operation or national emergency, or performing
                                                                                                        to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
qualifying National Guard duty during a war or other military operation or national
                                                                                                        (such as a deferment, forbearance, discharge, or forgiveness) under the FFEL Program,
emergency.
                                                                                                        to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to
My lender will process an in-school deferment based on (i) my request along with                        collect and report on your loan(s) if your loan(s) becomes delinquent or in default. We also
documentation verifying my eligibility, (ii) my lender’s receipt of information from my school          use your SSN as an account identifier and to permit you to access your account information
about my eligibility in connection with a new loan, or (iii) my lender’s receipt of student             electronically.
status information indicating that I am enrolled on at least a half-time basis. For all other
                                                                                                        The information in your file may be disclosed, on a case by case basis or under a computer
deferment types, I must provide my lender with a deferment request and evidence that
                                                                                                        matching program, to third parties as authorized under routine uses in the appropriate
verifies my eligibility.
                                                                                                        systems of records notices. The routine uses of this information include, but are not limited
If I did not consolidate all of my FFELP loans, the deferment options available to me for this          to, its disclosure to federal, state, or local agencies, to private parties such as relatives,
Federal Consolidation Loan will be based on the deferment provisions that are in effect for             present and former employers, business and personal associates, to consumer reporting
any outstanding loan(s) not consolidated, provided the deferment is authorized for Federal              agencies, to financial and educational institutions, and to guaranty agencies in order to
Consolidation Loans. (See Item 4, “Payment of Interest.”) My lender can provide additional              verify your identity, to determine your eligibility to receive a loan or a benefit on a loan,
information about deferment eligibility.                                                                to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s),
                                                                                                        to investigate possible fraud and to verify compliance with federal student financial aid
10. Forbearance – If I am unable to make my scheduled loan payments, the lender may                     program regulations, or to locate you if you become delinquent in your loan payments or
allow me to reduce my payment amount, to extend the time for making payments, or to                     if you default. To provide default rate calculations, disclosures may be made to guaranty
temporarily stop making payments as long as I intend to repay my loan. Allowing me to                   agencies, to financial and educational institutions or to state agencies. To provide financial
temporarily delay or reduce loan payments is called a forbearance. Interest charges continue            aid history information, disclosures may be made to educational institutions. To assist
to accrue during a forbearance period.                                                                  program administrators with tracking refunds and cancellations, disclosures may be
                                                                                                        made to guaranty agencies, to financial and educational institutions, or to federal or state
The lender may grant me forbearance due to poor health or other acceptable reasons.                     agencies. To provide a standardized method for educational institutions efficiently to submit
                                                                                                        student enrollment status, disclosures may be made to guaranty agencies or to financial and
My lender is generally not required to grant a forbearance and may require me to provide                educational institutions. To counsel you in repayment efforts, disclosures may be made to
my reasons for the request and other information.                                                       guaranty agencies, to financial and educational institutions, or to federal, state, or
                                                                                                        local agencies.
The lender may grant me a forbearance to eliminate a delinquency that persists even though
I am making scheduled installment payments. My lender may grant me an administrative                    In the event of litigation, we may send records to the Department of Justice, a court,
forbearance for up to 60 days in order to collect and process documentation supporting my               adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to
request for a deferment, forbearance, change in repayment plan, or consolidation.                       the litigation. If this information, either alone or with other information, indicates a potential
                                                                                                        violation of law, we may send it to the appropriate authority for action. We may send
Circumstances that require my lender to grant me forbearance if I provide appropriate
                                                                                                        information to members of Congress if you ask them to help you with federal student aid
documentation include:
                                                                                                        questions. In circumstances involving employment complaints, grievances, or disciplinary
n Serving in a medical or dental internship or residency program, if I meet certain criteria.           actions, we may disclose relevant records to adjudicate or investigate the issues. If provided
n Serving in a national service position for which I receive a national service education               for by a collective bargaining agreement, we may disclose records to a labor organization
  award under the National and Community Service Trust Act of 1993. In some cases,                      recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for
  the interest that accrues on a qualified loan during the service period will be paid by the           the purpose of performing any programmatic function that requires disclosure of records.
  Corporation for National and Community Service.                                                       Before making any such disclosure, we will require the contractor to maintain Privacy Act
                                                                                                        safeguards. Disclosures may also be made to qualified researchers under Privacy
n Qualifying for partial repayment of my loans under the Student Loan Repayment Program,                Act safeguards.
  as administered by the Department of Defense.
n Having a monthly debt burden for Title IV loans that collectively equals or exceeds 20                Financial Privacy Act Notice
  percent of my total monthly gross income (for up to three years).                                     Under the Right to Financial Privacy Act of 1978 (12 U.S.C. 3401-3421), the U.S.
n Being called to active duty in the U.S. Armed Forces.                                                 Department of Education will have access to financial records in your student loan file
                                                                                                        maintained by the lender in compliance with the administration of the Federal Family
If I choose not to pay the interest that accrues on my loan during any period of authorized             Education Loan Program.
forbearance, the interest may be capitalized to the extent permitted by the Act. Capitalization
of interest will result in the unpaid interest being added to the principal balance of the loan.        Paperwork Reduction Notice
                                                                                                        According to the Paperwork Reduction Act of 1995, no persons are required to respond
11. Applicability to Aggregate Loan Limits – If the loans I have selected for consolidation             to a collection of information unless it displays a currently valid OMB control number.
were made under the Federal or Direct Stafford (subsidized, nonsubsidized, or                           The valid OMB control number for this information collection is 1845-0036. The time
unsubsidized), SLS, Perkins, or HPSL loan programs, a percentage of the outstanding                     required to complete this information is estimated to average 1.0 hours (60 minutes) per
balance on my Federal Consolidation Loan will be counted towards the aggregate loan limits              response, including the time to review instructions, search existing data resources, gather
for each type of loan selected.                                                                         and maintain the data needed, and complete and review the information collection. If you
                                                                                                        have any comments concerning the accuracy of the time estimate(s) or suggestions for
12. Adding Loans – If I do not consolidate all eligible loans at this time, I understand that I
                                                                                                        improving this form, please write to:
may later add to this Federal Consolidation Loan an eligible loan(s) made before or after the
date of this consolidation by submitting a request to my lender. My lender must receive my              U.S. Department of Education
request within 180 days after the date on which my Federal Consolidation Loan is disbursed.             Washington, DC 20202-4651
After the 180-day period, no loan can be added to this Federal Consolidation Loan and I will
need to apply for a new Federal Consolidation Loan to consolidate any eligible loan(s).                 If you have any comments or concerns regarding the status of your individual submission
                                                                                                        of this form, contact the lender, guarantor, or program identified in the upper right-hand
                                                                                                        corner of this form.



                                                                                                Page 8 of 8
Federal Family Education Loan Program (FFELP)
                                                                                                           Guarantor, Program, or Lender Identification


Additional Loan Listing Sheet for Federal
Consolidation Loan Application and Promissory Note
WARNING:	Any	person	who	knowingly	makes	a	false	statement	or	misrepresentation	on	this	form	or	any	
accompanying	documents	is	subject	to	penalties	that	may	include	fines,	imprisonment,	or	both,	under	the	
U.S.	Criminal	Code	and	20	U.S.C.	1097.
Use this form only if you need additional space to list loans in Section D of the Federal Consolidation Loan Application and Promissory Note.

Borrower	Name	                                                                                                      	 ocial	Security	Number
                                                                                                                    S
Please	print	
Section D.1. Education Loan Indebtedness — Loans You Want to Consolidate (Continued)
Read the Instructions for Completing the Federal Consolidation Loan Application and Promissory Note before completing this section.	List	each	federal	education	loan	you	want	to	
consolidate,	including	each	loan	(if	any)	currently	held	by	the	lender	that	will	be	consolidating	your	loans.	Use	the	Loan	Codes	listed	in	the	instructions.	The	loan	holder/servicer	is	the	entity	
to	which	you	send	your	payments.		Be	sure	to	include	this	form	with	your	Application	and	Promissory	Note	when	you	submit	it.	List	each	loan	separately.	Please	print.		ONLY LIST LOANS
THAT YOU WANT TO CONSOLIDATE IN THIS SECTION.
15.	 Loan	Code         16.	 Loan	Holder/Servicer	Name	and	Mailing	Address                                           17.	 Loan	Account	Number          18.	 Interest	Rate   19.	 Estimated	Payoff	Amount
(See	Instructions)     (See	Instructions)	




Section D.2. Education Loan Indebtedness — Loans You Do Not Want to Consolidate (Continued)
Read the Instructions for Completing the Federal Consolidation Loan Application and Promissory Note before completing this section.	List	each	education	loan	that	you	are	not	consoli-
dating	but	want	considered	in	calculating	your	maximum	repayment	period.	Remember	to	include	each	loan	(if	any)	held	by	the	lender	that	will	be	consolidating	your	loans,	but	
that	you	do	not	want	to	include	in	your	Federal	Consolidation	Loan.	Use	the	Loan	Codes	listed	in	the	instructions.	The	loan	holder/servicer	is	the	entity	to	which	you	send	your	payments.	
Be	sure	to	include	this	form	with	your	Application	and	Promissory	Note	when	you	submit	it.	List	each	loan	separately.	Please	print.	ONLY LIST LOANS THAT YOU DO NOT WANT TO
CONSOLIDATE IN THIS SECTION.
21.	 Loan	Code        22.	 Loan	Holder/Servicer	Name	and	Mailing	Address                                            23.	 Loan	Account	Number          24.	 Interest	Rate   25.	 Current	Balance
(See	Instructions)    (See	Instructions)
                                                                                                                  Guarantor, Program, or Lender Identification
Federal Family Education Loan Program (FFELP)                                                                                                                                       OMB No. 1845-0036
                                                                                                                                                                                    Form approved
Request to Add Loans to a Federal Consolidation Loan                                                                                                                                Exp. date 01/31/2010

(180 Day Add-On Provision)
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any
accompanying documents is subject to penalties that may include fines, imprisonment, or both, under the
U.S. Criminal Code and 20 U.S.C. 1097.
Before You Begin
Use this form to request that your consolidating lender add an eligible education loan(s) that was not originally included in your Federal Consolidation Loan. This form must be completed,
signed and dated, and returned to your consolidating lender so that it is received within 180 days after the date the Federal Consolidation Loan was disbursed.
Before beginning, gather all your education loan records, account statements, and bills so that you have the information you need to complete this form. If an item has been completed for you
and it is incorrect, cross out the incorrect information and print the correct information. Incorrect or incomplete information may delay processing of your request to add loans to your Federal
Consolidation Loan. Print using a dark ink ballpoint pen or type.
If you have any questions about completing this Request to Add Loans to a Federal Consolidation Loan, contact your consolidating lender.
Section A. Borrower Information
1. Borrower Last Name                                                        First Name                                            MI              2. Social Security Number


Section B. Education Loan Indebtedness
Read the instructions before completing this section. List the federal education loans that you want added to your Federal Consolidation Loan. You may include those loans that were
disbursed before or after the date your Federal Consolidation Loan was made. Use the loan codes listed in the instructions. The loan holder/servicer is the entity to which you send your
payments. List each loan separately. Please print.

3. Loan Code          4. Loan Holder/Servicer Name and Mailing Address                                                    5. Loan Account Number            6. Interest Rate   7. Estimated Payoff Amount
(See Instructions,       (See Instructions)
Section B)




Section C. Promissory Note Addendum
I request that my consolidating lender repay the eligible federal education loan(s) identified in Section B and that the amount of my Federal Consolidation Loan be increased to include the
amount paid by my consolidating lender.
I understand that this request must be received by my consolidating lender within 180 days after the date my Federal Consolidation Loan was disbursed. I further understand that by adding
these loans my repayment term may be extended, my monthly payment amount may change, and my interest rate may change. My consolidating lender will send me a revised repayment
schedule and notify me of any other changes to the terms of my Federal Consolidation Loan.
My signature below certifies that I have read, understand, and agree to the terms and conditions of this loan, including all terms and conditions specified on the Federal Consolidation Loan
Application and Promissory Note which was previously submitted, including the Borrower Certification and Authorization, and the Borrower’s Rights and Responsibilities Statement that
accompanied it.
I UNDERSTAND THAT THIS IS A LOAN THAT I MUST REPAY.

8. Borrower’s Signature                                                                                                                             Today’s Date (mm-dd-yyyy)
   (Identified in Section A, Item 1 above.)



                                                                                                          Page 1 of 2
                                                                                                Guarantor, Program, or Lender Identification
Federal Family Education Loan Program (FFELP)
 Instructions for Completing the Request to Add Loans
 to a Federal Consolidation Loan and Important Notices
Section A. Borrower Information                                                                    Section D. Important Notices

Item 1: Enter your last name, first name, and middle initial.                                     Privacy Act Notice
Item 2: Enter or correct your Social Security Number.                                             The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided
                                                                                                  to you:
Section B. Education Loan Indebtedness                                                            The authority for collecting the requested information from and about you is §421 et seq.
The following types of education loans are eligible for consolidation:                            of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and the
                                                                                                  authorities for collecting and using your Social Security Number (SSN) are §§428B(f) and
Loan Code                    Education Loans                                                      484(a)(4)(B) of the HEA (20 U.S.C. 1078-2(f) and 1091(a)(4)(B)) and 31 U.S.C. 7701(b).
SS           Subsidized Federal Stafford Loans                                                    Participating in the Federal Family Education Loan (FFEL) Program and giving us your
DSS          Direct Subsidized Stafford/Ford Loans                                                SSN are voluntary, but you must provide the requested information, including your SSN,
US           Unsubsidized and Nonsubsidized Federal Stafford Loans                                to participate.
DUS          Direct Unsubsidized Stafford/Ford Loans
                                                                                                  The principal purposes for collecting the information on this form, including your SSN, are
PLUS         Federal PLUS Loans (for parents)
                                                                                                  to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
GB           Federal PLUS Loans (for graduate/professional students)
                                                                                                  (such as a deferment, forbearance, discharge, or forgiveness) under the FFEL Program,
DPLUS        Direct PLUS Loans (for parents)
                                                                                                  to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to
D3           Direct PLUS Loans (for graduate/professional students)
                                                                                                  collect and report on your loan(s) if your loan(s) becomes delinquent or in default. We also
SLS          Federal Supplemental Loans for Students
                                                                                                  use your SSN as an account identifier and to permit you to access your account information
PERK         Federal Perkins Loans and National Direct Student Loans
                                                                                                  electronically.
SCON         Subsidized Federal Consolidation Loans
DSCON        Direct Subsidized Consolidation Loans                                                The information in your file may be disclosed, on a case by case basis or under a computer
UCON         Unsubsidized Federal Consolidation Loans                                             matching program, to third parties as authorized under routine uses in the appropriate
DUCON        Direct Unsubsidized Consolidation Loans, including Direct PLUS                       systems of records notices. The routine uses of this information include, but are not limited
             Consolidation Loans                                                                  to, its disclosure to federal, state, or local agencies, to private parties such as relatives,
HPSL         Health Professions Student Loans, including Loans for                                present and former employers, business and personal associates, to consumer reporting
             Disadvantaged Students                                                               agencies, to financial and educational institutions, and to guaranty agencies in order to
HEAL         Health Education Assistance Loans                                                    verify your identity, to determine your eligibility to receive a loan or a benefit on a loan,
FISL         Federal Insured Student Loans                                                        to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s),
NSL          Federal Nursing Loans                                                                to investigate possible fraud and to verify compliance with federal student financial aid
                                                                                                  program regulations, or to locate you if you become delinquent in your loan payments or
Item 3: Enter the Loan Code that corresponds to the Education Loan type from the
                                                                                                  if you default. To provide default rate calculations, disclosures may be made to guaranty
above list. If you are not sure about the loan type, leave this item blank.
                                                                                                  agencies, to financial and educational institutions, or to state agencies. To provide financial
Information you need to answer the following items is available in loan documents,                aid history information, disclosures may be made to educational institutions. To assist
such as:                                                                                          program administrators with tracking refunds and cancellations, disclosures may be
n The last monthly billing statement you received,                                                made to guaranty agencies, to financial and educational institutions, or to federal or state
n Your quarterly interest statement or annual statement,                                          agencies. To provide a standardized method for educational institutions efficiently to submit
n Your coupon book, or                                                                            student enrollment status, disclosures may be made to guaranty agencies or to financial
n The Internet site of your loan holder or servicer.                                              and educational institutions. To counsel you in repayment efforts, disclosures may be made
If you are unsure of the correct information on your loans, contact the entity to which           to guaranty agencies, to financial and educational institutions, or to federal, state, or local
you send your payments, or check the most recent correspondence from that entity.                 agencies.
You may also obtain information on your loan(s) by accessing the National Student Loan            In the event of litigation, we may send records to the Department of Justice, a court,
Data System at http://www.nslds.ed.gov.                                                           adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary
Item 4: Enter the full name and mailing address of the holder of each of your federal             to the litigation. If this information, either alone or with other information, indicates a
education loans or the holder’s servicer. (This is the address to which you are or will           potential violation of law, we may send it to the appropriate authority for action. We
be sending your payments.) Do not use initials instead of full names. For a defaulted             may send information to members of Congress if you ask them to help you with federal
FFELP loan, the holder is the guaranty agency or the Department of Education. For a               student aid questions. In circumstances involving employment complaints, grievances,
defaulted Federal Direct Loan, the holder is the Department of Education. For a Perkins           or disciplinary actions, we may disclose relevant records to adjudicate or investigate the
Loan, the holder is the school.                                                                   issues. If provided for by a collective bargaining agreement, we may disclose records to
Item 5: Enter the account number for each loan.                                                   a labor organization recognized under 5 U.S.C. Chapter 71. Disclosures may be made to
                                                                                                  our contractors for the purpose of performing any programmatic function that requires
Item 6: Enter the interest rate you are paying on each loan.
                                                                                                  disclosure of records. Before making any such disclosure, we will require the contractor
Item 7: Enter the estimated payoff amount, including any unpaid interest, late fees and           to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers
         collection costs.                                                                        under Privacy Act safeguards.
Section C. Promissory Note Addendum                                                               Financial Privacy Act Notice
                                                                                                  Under the Right to Financial Privacy Act of 1978 (12 U.S.C. 3401-3421), the U.S.
To be completed by the borrower.                                                                  Department of Education will have access to financial records in your student loan file
This is a legally binding contract.                                                               maintained by the lender in compliance with the administration of the Federal Family
Item 8: Sign and date the Promissory Note Addendum.                                               Education Loan Program.
Note: Signature is required. If you fail to sign the Promissory Note Addendum, your               Paperwork Reduction Notice
request will be delayed.                                                                          According to the Paperwork Reduction Act of 1995, no persons are required to respond
Review all information you have provided on this form. When it is complete, send the              to a collection of information unless it displays a currently valid OMB control number. The
original copy to the consolidating lender. Keep a copy for your records. Remember                 valid OMB control number for this information collection is 1845-0036. The time required
to continue making your regularly scheduled education loan payments until your                    to complete this information is estimated to average 0.16666 hours (10 minutes) per
consolidating lender notifies you that the loan(s) has been added. When your loan(s)              response, including the time to review instructions, search existing data resources, gather
is added, your consolidating lender will notify you of any changes to the terms of your           and maintain the data needed, and complete and review the information collection.
Federal Consolidation Loan.                                                                       If you have any comments concerning the accuracy of the time estimate(s) or
Mailing Instructions: Mail the original copy of this form to your consolidating lender.           suggestions for improving this form, please write to:
                                                                                                  U.S. Department of Education
                                                                                                  Washington, DC 20202-4651
                                                                                                  If you have any comments or concerns regarding the status of your individual submission
                                                                                                  of this form, contact the consolidating lender.




                                                                                          Page 2 of 2
                                                                                                                   Guarantor, Program, or Lender Identification
    Federal Family Education Loan Program (FFELP)                                                                                                                                                  OMB No. 1845-0036
                                                                                                                                                                                                   Form approved

    Federal Consolidation Loan
                                                                                                                                                                                                   Exp. date 01/31/2010


    Verification Certificate
The Federal Consolidation Loan Program enables borrowers to apply for a federally guaranteed loan to consolidate outstanding education loans pursuant to Title IV of the Higher Education Act
of 1965, as amended. The borrower identified in Item 3 of this Certificate has requested consolidation of his/her eligible education loan(s). Eligible loans are identified under Loan Codes listed
in the Federal Consolidation Loan Verification Certificate Instructions. This form is used to verify the eligibility and the payoff amount of the borrower’s outstanding education loan(s) selected
for consolidation. As part of the Federal Consolidation Loan Application, the borrower named in Item 3 has authorized your disclosure of information regarding the education loan(s) listed
below. Please verify and/or complete ALL items and return this form to the entity identified in Item 19. Pay special attention to Item 6, Loan Code. This Loan Verification Certificate will be
relied on by the consolidating lender in paying off the listed loan(s).
Federal regulations require that you complete and return this form within 10 business days. See the instructions for details on completing this form.

(1)    Holder/Servicer Name and Address                                                                          (2)     Institution and Address to which payoff amount should be sent
                                                                                                                         (if different from Item 1).

                                                                                                                         Name __________________________________________________________
                                                                                                                         Street __________________________________________________________
                                                                                                                         City _____________________________ State_________ Zip ___________
                                                                                                                         Telephone (         ) ____________________________________________
                                                                                                                         Contact Name ____________________________________________________

(3)    Borrower Social Security Number, Name, Address, and Telephone Number                                      (4)     Anticipated Loan Payoff Date
                                                                                                                         (mm-dd-yyyy)




      (5) Account Number          (6) Loan Code     (7) Current         (8) First/Only    (9) Interest   (10) Borrower     (11) Grace End       (12) First/Next       (13) Current      (14) Payoff Amount      (15) Daily
                                                    Guarantor or     Disbursement Date        Rate        Status Code           Date             Payment Due            Principal         as of Anticipated      Interest
                                                    Program Code       (mm-dd-yyyy)                                         (mm-dd-yyyy)        (mm-dd-yyyy)            Balance          Loan Payoff Date1       Accrual




                                                                                                                                            (16) Total Payoff Amount1

Collection Costs: If a defaulted Federal Stafford, SLS, PLUS, or Consolidation loan is held by a guaranty agency, collection costs may not exceed 18.5 percent of the outstanding principal and interest.
1




(17) Additional Comments

(18) Holder/Servicer Certification: (a) To the best of my knowledge and belief, the information on this form is accurate and complete; (b) Each loan listed above is a legal, valid,
     and binding obligation of the borrower; (c) Each such loan was made and serviced in compliance with all applicable laws and regulations; (d) In the case of Federal Stafford
     [subsidized, nonsubsidized, and unsubsidized (GSL)], Federal PLUS, Federal SLS (ALAS), Federal Consolidation, and Federal Insured Student Loans (FISL) held by the
     lender, the insurance on each such loan is in full force and effect; and (e) The loan amounts confirmed include only unpaid principal, unpaid accrued interest for which the
     borrower is responsible, late charges (as defined by federal regulations), and eligible collection costs.



___________________________________________________                                 ____________________________________________________________                                        ________________________
 Signature of Authorized Official                                                    Holder/Servicer Name                                                                                Today’s Date (mm-dd-yyyy)


___________________________________________________                                   (           ) _______________________________________________                                     ________________________
 Name and Title of Authorized Official (Please Print)                                 Area Code and Telephone Number                                                                     Lender/School/Guarantor
                                                                                                                                                                                         ED Code
For information or assistance when completing this certificate, please contact the consolidating lender.
(19) Return original to:                                           Or fax to:
Federal Consolidation Loan Verification Certificate Instructions
The borrower named in the Certificate has requested consolidation of his/her eligible education loan(s). As part of his/her application for a Federal Consolidation Loan, the borrower authorizes each educa-
tion loan holder/servicer to complete a Loan Verification Certificate. The consolidating lender will use the Loan Verification Certificate to determine the eligibility of loans for inclusion in the consolidation
and the payoff amount due to each creditor. After receiving the Loan Verification Certificate and the documents required from the applicant, the consolidating lender will pay off the borrower’s debt(s) based
on the information provided on the Certificate. Upon receipt of payment, the loan holder must return the original or a copy of the Promissory Note or provide other acceptable notice to the borrower (as if
the borrower personally paid the loan in full). Any overpayments or subsequent borrower payments are to be sent to the consolidating lender so they may be applied to the borrower’s outstanding principal
balance in accordance with Department of Education guidelines.
Consolidation Lender Instructions:                                      for this borrower, please list each loan separately. If the               the payoff for each loan, which is the sum of the following, as of
                                                                        account number is the same for each loan, enter “same” on the             the anticipated payoff date in Item 4:
Enter dates as month-day-year (mm-dd-yyyy). Use only                    subsequent accounts.
                                                                                                                                                     a)     principal outstanding (including capitalized interest);
numbers. Example: June 24, 1982 = 06-24-1982.                           Item 6: Complete or correct the loan code using the                          b)     unpaid accrued interest;
Using information from the borrower’s application, complete             abbreviations from the list below.
                                                                                                                                                     c)     unpaid late charges, if applicable (as defined by federal
Items 1 and 3 - 6.                                                      Item 7: Enter the guarantor or program code from the list below.                    regulations); and
Holder/Servicer Instructions:                                           Item 8: Enter the first, or only, disbursement date                          d)     eligible collection costs, (not to exceed 18.5 percent of
Please complete Items 2 and 7 - 18 and confirm that the                 for each loan.                                                                      the outstanding principal and interest on a FFELP loan in
information provided is accurate.                                                                                                                           default and held by a guaranty agency), if applicable.
                                                                        Item 9: Enter the interest rate for each loan.
Item 1: Complete or correct holder/servicer name and address if                                                                                   Item 15: Enter the daily interest accrual factor (per diem) used
                                                                        Item 10: Enter the current status of the borrower’s accounts              in completing Item 14 for each loan. The interest accrual factor is
different than printed.                                                 using the status codes from the list below.                               calculated by multiplying the outstanding principal balance of the
Item 2: If the payoff check should be sent to a different               Item 11: For each loan, enter the grace period end date,                  loan by the interest rate divided by 365.25 or the actual number
institution or address than that shown in Item 1, complete this         if applicable.                                                            of days in the calendar year.
information.
                                                                        Item 12: Enter the account’s next payment due date. If the                Item 16: Enter the total payoff amount due the holder shown on
Item 3: Enter or correct the borrower’s Social Security Number,         account is in grace period status, enter the anticipated first            this Certificate.
full name, address, and telephone number.                               payment date. If the account is delinquent, enter the borrower’s          Item 17: Enter any appropriate comments. If unable to complete
Item 4: Enter the anticipated loan payoff date provided by the          most delinquent payment due date.                                         all or any portion of this Certificate, please explain here.
consolidating lender. If the consolidating lender did not provide a     Item 13: Enter the current principal balance of each loan
loan payoff date, enter a date which is 30 days from the date you                                                                                 Item 18: Provide signature along with required information of
                                                                        (including capitalized interest).                                         authorized official.
receive the Certificate.
                                                                        Item 14: Assume that no payments will be made by the
Item 5: Complete or correct the account number assigned to              borrower from now until the anticipated loan payoff date. Provide
the borrower’s education loan(s). If you have multiple accounts

                                             Complete and return this Certificate to the consolidating lender within 10 business days of receipt.
Loan Codes (for Item 6)
SS           Subsidized Federal Stafford Loans                          D3            Direct PLUS Loans (for graduate/professional               DUCON        Direct Unsubsidized Consolidation Loans, including
DSS          Direct Subsidized Stafford/Ford Loans                                    students)                                                               Direct PLUS Consolidation Loans
US           Unsubsidized and Nonsubsidized Federal                     SLS           Federal Supplemental Loans for Students                    HPSL         Health Professions Student Loans, including Loans
             Stafford Loans                                             PERK          Federal Perkins Loans and National Direct Student                       for Disadvantaged Students
DUS          Direct Unsubsidized Stafford/Ford Loans                                  Loans                                                      HEAL         Health Education Assistance Loans
PLUS         Federal PLUS Loans (for parents)                           SCON          Subsidized Federal Consolidation Loans                     FISL         Federal Insured Student Loans
GB           Federal PLUS Loans (for graduate/professional              DSCON         Direct Subsidized Consolidation Loans                      NSL          Federal Nursing Loans
             students)                                                  UCON          Unsubsidized Federal Consolidation Loans
DPLUS        Direct PLUS Loans (for parents)

Guarantor or Program Codes (for Item 7)
Abbrev. Name                                                            Abbrev.       Name                                                       Abbrev.      Name
AES/PHEAA    American Education Services (PHEAA)                        ICSAC         Iowa College Student Aid Comm., formerly ICAC              OSRHE        Oklahoma State Regents for Higher Ed.
ASA          American Student Assistance, formerly MHEAC                KHEAA         Kentucky Higher Ed. Assistance Authority                   RIHEAA       Rhode Island Higher Ed. Assist. Authority
CSAC         California Student Aid Commission                          LASFAC        Louisiana Student Financial Assistance Commission,         SCSLC        South Carolina Student Loan Corp., formerly
CSLP         Colorado Student Loan Program                                            formerly LGSCES                                                         SCSEAA
CSLF         Connecticut Student Loan Foundation                        MHEAA         Michigan Higher Ed. Assistance Authority                   SLGFA        Student Loan Guarantee Foundation of Arkansas
EAC          Education Assistance Corp. (South Dakota)                  MDHE          Missouri Department of Higher Education Student            SLND         Student Loans of North Dakota, formerly NDGSLP
                                                                                      Loan Program, formerly MSLP                                TSAC         Tennessee Student Assistance Corporation
ECMC         Education Credit Mgmt. Corp., formerly TGA
                                                                        MGSLP         Montana Guaranteed Student Loan Prog.                      TG           Texas Guaranteed Student Loan Corporation
FDLP         Federal Direct Loan Program
                                                                        NSLP          National Student Loan Program, formerly Nebraska           USAF         United Student Aid Funds, Inc.
FAME         Finance Authority of Maine, formerly MDECS
                                                                                      Student Loan Program, Inc.
OSFA         Florida Department of Education, Office of Student                                                                                  USED         U.S. Department of Education Federal Insured
                                                                        NHHEAF        New Hampshire Higher Education Assist. Foundation                       Student Loan Program (FISL) and subrogated
             Financial Assistance, formerly BSFA
                                                                        NJHESAA       New Jersey Higher Education Student Assistance                          FFELP loans
GHEAC        Georgia Higher Education Assistance Corp.
                                                                                      Authority                                                  UHEAA        Utah Higher Ed. Assistance Authority
GLHEC        Great Lakes Higher Education Corporation
                                                                        NMSLGC        New Mexico Student Loan Guarantee Corporation              VSAC         Vermont Student Assistance Corporation
HHS          U.S. Dept. of Health & Human Services
                                                                        NYSHESC       New York State Higher Ed. Services Corp.
ISAC         Illinois Student Assistance Commission,
                                                                        NCSEAA        North Carolina State Ed. Assistance Authority
             formerly ISSC
                                                                        NELA          Northwest Education Loan Association

Borrower Status Codes (for Item 10)
IS           In School                                                  BA            Bankruptcy (Claim Not Filed, to be Filed, or Paid)         DN           Default Claim Paid - Satisfactory Repayment
GR           Grace                                                      DQ            270 Days + Delinquent, Claim Not Paid                                   Arrangements Not Made
RP           Repayment                                                  DS            Default Claim Paid - Satisfactory Repayment                DI           Currently Subject to Judgment or Wage
                                                                                      Arrangements Made                                                       Garnishment Order
DE           Deferment
                                                                                                                                                 OT           Other (Explain in Item 17)
FB           Forbearance

Paperwork Reduction Notice
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The valid OMB control
number for this information collection is 1845-0036. The time required to complete this information is estimated to average 0.15 hours (9 minutes) per response, including the time to review instructions,
search existing data resources, gather and maintain the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or
suggestions for improving this form, please write to:

U.S. Department of Education
Washington, DC 20202-4651
 Repayment Information (Federal Consolidation Loan)
    Repayment Schedules

 You may choose one of the repayment schedules described below for your Federal Consolidation Loan, and you will have
 a repayment period of 10 to 30 years depending on your total education loan debt:

     Standard Payments - This schedule provides standard, equal monthly payments. The final payment may be slightly larger or
     smaller.
     Graduated Payments - A graduated repayment schedule allows for payments to be smaller at the beginning of repayment,
     with the payments increasing over the course of the repayment period on the loan. If a graduated repayment schedule is
     established, no installment may be more than three times the amount of any other installment. Selecting a graduated
     repayment schedule may increase your costs.
     Income-Sensitive Payments - This schedule establishes payments annually based on your expected total monthly gross
     income from employment and all other sources. If an income-sensitive repayment schedule is established, no installment may
     be more than three times the amount of any other installment. Selecting an income-sensitive repayment schedule may
     increase your costs. If you select this schedule, you may initially be set up under a standard or graduated repayment schedule
     as explained in Section E of the application.
     Extended Payments - This schedule allows borrowers with FFELP loans in excess of $30,000 to repay their debt over a 25-
     year period. Under the other repayment schedules, you must have at least $40,000 in debt to qualify for a 25-year repayment
     period. If you have debt in excess of $60,000 and wish to repay it over 30 years, you should select one of the other repayment
     schedules.

 If you do not notify your lender of your choice of repayment schedule or do not provide your lender with the documentation
 required for an income-sensitive repayment schedule, your lender will establish a standard repayment schedule for your
 Consolidation loan.

 Prior to selection of your repayment schedule, it is important for you to determine the estimated total amount of your Federal
 Consolidation Loan and to calculate the interest rate of the loan based on the weighted average of the loans being consolidated.
 This information will assist you in projecting an estimated monthly payment.


    Step 1: Determine Your Estimated Federal               (1) Loan Type    (2) Estimated Current      (3) Interest    (4) Interest
    Consolidation Loan Amount                                               Balance                    Rate            Factor

    Column 1. Enter the loan type of each loan you                          $
    want to consolidate (e.g., Subsidized Stafford,
    PLUS, etc.).
    Column 2. Enter the estimated current balance
    for each loan and total.
    Column 3. Enter the interest rate of each loan.
    Column 4. See Step 2 for instructions.




                                                           Total            $


Step 2: Determine Your Estimated Federal Consolidation                Treasury Bills auctioned for the quarter ending June 30, plus
Loan Interest Rate                                                    3.0%. If you have a HEAL loan included in your Federal
                                                                      Consolidation Loan, you may have up to two interest rates on
Except for the portion of your loan attributable to HEAL loans,       the loan — fixed and variable.
the interest rate for your Federal Consolidation Loan will be the
weighted average of the interest rates of the loans being             Instructions for Calculating the Estimated Weighted
consolidated, rounded up to the nearest 1/8th percent, not to         Average Interest Rate
exceed 8.25 percent. Use the instructions to the right to
calculate the weighted average interest rate.                         1.   Multiply each estimated current balance in column 2 by
                                                                           the interest rate in Column 3. Enter those figures in
For any portion of the loan attributable to HEAL loans, the                Column 4 and total.
interest rate is variable and adjusts each July 1. The interest       2.   Divide the total of Column 4 by the total estimated current
rate is the average of the bond equivalent rates of the 91-day             balance (Column 2).

 Revised 3/22/2007
    _______ (Total Column 4) ÷ $ ________ (Total Column
   2) = ________%
   Round this figure upward to the nearest 1/8th percent
        _____% (not to exceed 8.25 percent). This is the
   estimated weighted average interest rate.




Revised 3/22/2007
Repayment Information (continued)
Length of Repayment Period

The following table shows the maximum repayment period available based on your estimated Federal Consolidation Loan amount
and other outstanding education loans.*

Less than $7,500                = 10 years        $20,000 to $39,999.99              = 20 years
$7,500 to $9,999.99             = 12 years        $40,000 to $59,999.99              = 25 years
$10,000 to $19,999.99           = 15 years        $60,000 and above                  = 30 years

Note: You can request a repayment period that is shorter than the maximum allowed. Selecting a shorter repayment period will decrease
your interest costs.

*You may qualify for a longer repayment period (which would reduce your monthly payment) if you have other outstanding eligible
education loans not being consolidated or other education loans that are not eligible for consolidation but meet the following description:
Loans must have been obtained from an institution that makes loans such as banks, schools, or state agencies under a public or private
loan program exclusively to finance postsecondary education. (Personal loans from family or friends or loans in default may not be
included.) If you have other outstanding education loans that are not being included in this Federal Consolidation Loan, and you would like
the balance(s) of the loan(s) to be used to determine the repayment period on your Federal Consolidation Loan, be certain to list such
loan(s) on the Federal Consolidation Loan Application and Promissory Note, Section D.2.

Standard Payments — Estimated Monthly Payment

Using the estimated Federal Consolidation Loan amount that you determined in Step 1 and the estimated interest rate that you
calculated in Step 2, you can use the following table to determine your estimated monthly payment. The repayment table provides
for estimated standard monthly payments for the maximum number of years allowed. If you are consolidating HEAL loans, contact
the consolidating lender for information on estimating your monthly payment.

                                 4%                        5%                        6%                        7%                        8%
Principal
             Term     Monthly           Total    Monthly          Total    Monthly          Total    Monthly          Total    Monthly          Total
Amount
            (Years)   Payment         Interest   Payment        Interest   Payment        Interest   Payment        Interest   Payment        Interest
of Loan
                                      $1,075                                              $1,661
                        $51                        $53          $1,364       $56                       $59          $1,967       $61          $2,280
$5,000        10
$7,500        12        $66           $1,956       $70          $2,489       $74          $3,040       $78          $3,607       $82          $4,191
$10,000       15        $74           $3,315       $80          $4,235       $85          $5,190       $90          $6,177       $96          $7,201
$12,500       15        $93           $4,143       $99          $5,293      $106          $6,487      $113          $7,724      $120          $9,003
$15,000       15       $111           $4,972      $119          $6,352      $127          $7,785      $135          $9,268      $144          $10,803
$20,000       20       $122           $9,087      $132          $11,678     $144          $14,389     $156          $17,215     $168          $20,150
$25,000       20       $152           $11,359     $165          $14,598     $180          $17,986     $194          $21,518     $210          $25,187
$30,000       20       $182           $13,631     $198          $17,517     $215          $21,583     $233          $25,822     $251          $30,224
$35,000       20       $213           $15,903     $231          $20,437     $251          $25,181     $272          $30,126     $293          $35,261
$45,000       25       $238           $26,258     $264          $33,920     $290          $41,981     $319          $50,416     $348          $59,196

$60,000       30       $287           $43,122     $323          $55,954     $360          $69,503     $400          $83,706     $441          $98,494

The total interest listed assumes payments received on time as scheduled.

Graduated Payments — Estimated Monthly Payment

Lenders can offer a variety of graduated payment schedules provided they comply with federal regulations. [Payment examples to
be added to this section by the lender/guarantor.]

Income-Sensitive Payments — Estimated Monthly Payment

Based on the income documentation that you provide, your lender will make a determination of your monthly payment. [Payment
examples to be added to this section by the lender/guarantor.]

Extended Payments — Estimated Monthly Payment

Extended repayment allows borrowers with FFELP loans in excess of $30,000 to repay their debt over a 25-year period. Under the
other repayment schedules, you must have at least $40,000 in debt to qualify for a 25-year repayment period. If you have debt in
excess of $60,000 and wish to repay it over 30 years, you should select one of the other repayment schedules.


Revised 3/22/2007
 Repayment Information (continued)
 Capitalization Information
What Is Capitalization?
Capitalization is a process whereby a lender adds unpaid interest to the principal balance of a loan. You are responsible for paying
the interest that accrues on your Federal Consolidation Loan from the date the lender disburses the loan proceeds to the holders of
the loans being consolidated until your Federal Consolidation Loan is paid in full. Depending on the loan types included in your
Federal Consolidation Loan, you may qualify to have the federal government pay the interest on your loan or a portion of your loan
during an authorized deferment period. Any unpaid interest on your loan may be capitalized. Capitalization may occur no more
frequently than quarterly.

If you are granted a deferment (and you are responsible for interest that accrues during such periods) or forbearance and you
choose to defer payment and capitalize interest charges, the principal balance of your loan will increase each time your lender
capitalizes unpaid interest. As a result, you will pay more interest over the life of the loan. When you resume repayment, your
monthly payment amount will be higher or you will make more payments.

Contact your consolidating lender if you have any questions or need more information.



 Capitalization for Loans                                                Option 1: Interest                Option 2: Interest
 at 8% Interest Rate                   Loan             Monthly           Payment Made                     Payment Deferred
 This chart compares the              Amount            Interest             Monthly            Interest              Monthly
 monthly payments on loans in                                                Payment           Capitalized            Payment
 a deferment or forbearance
 status where the interest is         $5,000             $34.00           $61 (120 months)        $413            $66 (120 months)
 paid (Option 1) and where the
 interest is capitalized (Option      $7,500             $50.00           $82 (144 months)        $619            $88 (144 months)
 2). The estimate of interest
                                      $10,000            $67.00           $96 (180 months)        $826            $104 (180 months)
 capitalized in these examples
 is based on quarterly                $15,000           $100.00          $144 (180 months)        $1,237          $156 (180 months)
 capitalization over a 12-month
 period.                              $20,000           $134.00          $168 (240 months)        $1,651          $182 (240 months)




Revised 3/22/2007
                 Private Education Loan                                                                                                               OMB No. 1845-0101
                                                                                                                                                      Form Approved
                                                                                                                                                      Exp. Date 02-28-2013
                 Applicant Self-Certification
________________________________________________________________________________________________
Important: Pursuant to Section 155 of the Higher Education Act of 1965, as amended, (HEA) and to satisfy the requirements of Section 128(e)(3) of the Truth in
Lending Act, a lender must obtain a self-certification signed by the applicant before disbursing a private education loan. The school is required on request to provide
this form or the required information only for students admitted or enrolled at the school. Throughout this Applicant Self-Certification, “you” and “your” refer to the
applicant who is applying for the loan. The applicant and the student may be the same person.

Instructions: Before signing, carefully read the entire form, including the definitions and other information on the following page. Submit the signed form
to your lender.
 SECTION 1: NOTICES TO APPLICANT
     Free or lower-cost Title IV federal, state, or school student financial aid may be available in place of, or in addition to, a private
      education loan. To apply for Title IV federal grants, loans and work-study, submit a Free Application for Federal Student Aid
      (FAFSA) available at www.fafsa.ed.gov, or by calling 1-800-4-FED-AID, or from the school’s financial aid office.
     A private education loan may reduce eligibility for free or lower-cost federal, state, or school student financial aid.
     You are strongly encouraged to pursue the availability of free or lower-cost financial aid with the school’s financial aid office.
     The financial information required to complete this form can be obtained from the school’s financial aid office. If the lender has
      provided this information, you should contact your school’s financial aid office to verify this information and to discuss your
      financing options.
 SECTION 2: COST OF ATTENDANCE AND ESTIMATED FINANCIAL ASSISTANCE
If information is not already entered below, obtain the needed information from the school’s financial aid office and enter it on the appropriate line. Sign
and date where indicated.

       A. Student’s cost of attendance for the period of enrollment covered by the loan                  $____________________
       B. Estimated financial assistance for the period of enrollment covered by the loan                $____________________
       C. Difference between amounts A and B                                                             $____________________
           WARNING: If you borrow more than the amount on line C, you risk reducing your eligibility for
          free or lower-cost federal, state, or school financial aid.
 SECTION 3: APPLICANT INFORMATION
Enter or correct the information below.

Full Name and Address of School ________________________________________________________________________________________________________

Applicant Name (last, first, MI) ___________________________________________________                  Date of Birth (mm/dd/yyyy) _____/_____/__________

Permanent Street Address __________________________________________________________________

City, State, Zip Code __________________________________________________________________ ____________________

Area Code / Telephone Number Home (             ) ____________________________              Other (      ) ____________________________
E-mail Address________________________________________________________________________________________
Period of Enrollment Covered by the Loan (mm/dd/yyyy)         From _____ / _____ / _______ to _____ / _____ / _______

If the student is not the applicant, provide the student’s name and date of birth.

Student Name (last, first, MI) ____________________________________________________                   Student Date of Birth (mm/dd/yyyy) _____/_____/__________

 SECTION 4: APPLICANT SIGNATURE

I certify that I have read and understood the notices in Section 1 and, that to the best of my knowledge, the information provided on this form is true and correct.

Signature of Applicant ____________________________________________________________________ Date (mm/dd/yyyy) _______________________

                                                                                2/12/2010
 SECTION 5: DEFINITIONS

Cost of attendance is an estimate of tuition and fees, room and board, transportation, and other costs for the period of enrollment covered by the loan, as
determined by the school. A student’s cost of attendance may be obtained from the school’s financial aid office.

Estimated financial assistance is all federal, state, institutional (school), private, and other sources of assistance used in determining eligibility for most Title IV
student financial aid, including amounts of financial assistance used to replace the expected family contribution. The student’s estimated financial assistance is
determined by the school and may be obtained from the school’s financial aid office.

A lender is a private education lender as defined in Section 140 of the Truth in Lending Act and any other person engaged in the business of securing, making, or
extending private education loans on behalf of the lender.

A period of enrollment is the academic year, academic term (such as semester, trimester, or quarter), or the number of weeks of instructional time for which the
applicant is requesting the loan.

A private education loan is a loan provided by a private education lender that is not a Title IV loan and that is issued expressly for postsecondary education
expenses, regardless of whether the loan is provided through the school that the student attends or directly to the borrower from the private education lender. A
private education loan does not include (1) An extension of credit under an open-end consumer credit plan, a reverse mortgage transaction, a residential mortgage
transaction, or any other loan that is secured by real property or a dwelling; or (2) An extension of credit in which the school is the lender if the term of the extension
of credit is 90 days or less or an interest rate will not be applied to the credit balance and the term of the extension of credit is one year or less, even if the credit is
payable in more than four installments.

Title IV student financial aid includes the Federal Pell Grant Program, the Academic Competitiveness Grant (ACG) Program, the Federal Supplemental Educational
Opportunity Grant (FSEOG) Program, the Leveraging Educational Assistance Partnership (LEAP) Program, the Federal Family Education Loan Program (FFELP),
the Federal Work-Study (FWS) Program, the William D. Ford Federal Direct Loan (Direct Loan) Program, the Federal Perkins Loan Program, the National Science
and Mathematics Access to Retain Talent Grant (National SMART Grant) Program, and the Teacher Education Assistance for College and Higher Education
(TEACH) Grant Program. To apply for Title IV federal grants, loans, and work-study, submit a Free Application for Federal Student Aid (FAFSA), which is available at
www.fafsa.gov, by calling 1-800-4-FED-AID, or from the school’s financial aid office.


 SECTION 6: PAPERWORK REDUCTION NOTICE

Paperwork Reduction Notice: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information
unless it displays a currently valid OMB control number. The valid OMB control number for this information collection is 1845-0101. The time required to
complete this information collection is estimated to average 0.25 hours (15 minutes) per response, including the time to review instructions, search
existing data resources, gather and maintain the data needed and complete and review the information collection.

If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S.
Department of Education, Washington, DC 20202-4651.

If you have any comments or concerns regarding the status of your individual submission of this form, contact your lender.




                                                                                  2/12/2010
  Treatment Of Title IV Funds When A Student Withdraws From A Credit-Hour Program
Student’s Name                                                                 Social Security Number
Date form
completed                  /                /                           Date of school’s determination
                                                                                 that student withdrew                        /              /
Period used for calculation (check one)                                 Payment period                    Period of enrollment

                        Monetary amounts should be in dollars and cents (rounded to the nearest penny).
                When calculating percentages, round to three decimal places. (For example, .4486 = .449, or 44.9%)

STEP 1: Student’s Title IV Aid Information
                                                                                      Amount that Could
                                                                                                              E. Total Title IV aid disbursed for the
     Title IV Grant Programs                          Amount Disbursed               Have Been Disbursed         period.
1. Pell Grant                                                                                                            A.
2. Academic Competitiveness Grant                                                                                    +   B.
3. National SMART Grant
                                                                                                              = E. $                          .
4. FSEOG                                                                                                      F. Total Title IV grant aid disbursed and that
5. TEACH Grant                                                                                                   could have been disbursed for the
                                                                                                                 period.

                                                A.                             C.                                        A.
                                                           Subtotal                        Subtotal                  +   C.

          Title IV Loan Programs                     Net Amount Disbursed
                                                                                     Net Amount that Could
                                                                                     Have Been Disbursed
                                                                                                              =      F. $                     .
                                                                                                              G. Total Title IV aid disbursed and that could
6. Unsubsidized FFEL / Direct Stafford Loan                                                                      have been disbursed for the period.
7. Subsidized FFEL / Direct Stafford Loan
8. Perkins Loan                                                                                                          A.
9. FFEL / Direct PLUS (Graduate Student)
                                                                                                                         B.
                                                                                                                         C.
10. FFEL / Direct PLUS (Parent)
                                                                                                                     +   D.
                                                B.                             D.                             =      G. $                     .
                                                         Subtotal                          Subtotal

STEP 2: Percentage of Title IV Aid Earned                                       STEP 3: Amount of Title IV Aid Earned by the Student
      /         /              /      /                   /         /            Multiply the percentage of Title IV aid earned (Box H) by
                                                                                 the Total Title IV aid disbursed and that could have been
     Start date         Scheduled end date Date of withdrawal                    disbursed for the period (Box G).
 A school that is not required to take attendance may, for a

                                                                                               %x                         =
 student who withdraws without notification, enter 50% in
 Box H and proceed to Step 3. Or, the school may enter the                                                                     I. $                     .
 last date of attendance at an academically related activity                           Box H                 Box G
 for the “withdrawal date,” and proceed with the calculation
 as instructed. For a student who officially withdraws, enter                   STEP 4: Title IV Aid to be Disbursed or Returned
 the withdrawal date.
                                                                                       If the amount in Box I is greater than the amount in
H. Percentage of payment period or period of                                           Box E, go to Post-withdrawal disbursement (Item J).
   enrollment completed
   Divide the calendar days completed in the period by the                             If the amount in Box I is less than the amount in
   total calendar days in the period (excluding scheduled                              Box E, go to Title IV aid to be returned (Item K).
   breaks of five days or more AND days that the student                               If the amounts in Box I and Box E are equal, STOP.
   was on an approved leave of absence).                                               No further action is necessary.
                                                                                    J. Post-withdrawal disbursement
                      ÷                          =              . %                    From the Amount of Title IV aid earned by the student
   Completed days              Total days                                              (Box I) subtract the Total Title IV aid disbursed for the
                                                                                       period (Box E). This is the amount of the post-
                                                                                       withdrawal disbursement.
     If this percentage is greater than 60%, enter 100% in
     Box H and proceed to Step 3.                                                      Stop here, and enter the amount in Box 1 on Page 3
                                                                                       (Post-withdrawal disbursement tracking sheet).
     If this percentage is less than or equal to 60%, enter
     that percentage in Box H,                                                                        –                   =   J. $                      .
     and proceed to Step 3.              H.                     . %                    Box I                 Box E                          Step 4 continued
                    You may use this form when the withdrawal date is on or after 11/01/2007                                                      p. 1 of 3
                                                                    Treatment Of Title IV Funds When A Student Withdraws From A Credit-Hour Program

Student’s Name                                                     Social Security Number

STEP 4: Aid to be Disbursed or Returned CONTINUED                   STEP 7: Initial Amount of Unearned Title IV Aid Due
K. Title IV aid to be returned                                                    from the Student
   From the Total Title IV aid disbursed for the period            From the amount of Title IV aid to be returned (Box K) subtract the
                                                                   Amount for the school to return (Box O).
   (Box E) subtract the amount of Title IV aid earned by
   the student (Box I). This is the amount of Title IV aid                           –                      =    Q.                        .
   that must be returned.                                                Box K                 Box O

                –                 =   K. $                 .             If Box Q is ≤ zero, STOP. If greater than zero, go to Step 8
     Box E             Box I                                       STEP 8: Repayment of the Student’s loans
                                                                    From the Net loans disbursed to the student (Box B) subtract the
STEP 5: Amount of Unearned Title IV Aid Due                         Total loans the school must return (Box P) to find the amount of
             from the School                                        Title IV loans the student is still responsible for repaying (Box R).
L. Institutional charges for                                        These outstanding loans consist either of loan funds the student
                                   Tuition                          has earned, or unearned loan funds that the school is not
   the period
                                   Room                             responsible for repaying, or both; and they are repaid to the loan
                                   Board                            holders according to the terms of the borrower’s promissory note.
                                    Other
                                                                                      –                      = R. $                        .
                                    Other                                 Box B                Box P
                                    Other                                If Box Q is less than or equal to Box R, STOP.
                                                                         The only action a school must take is to notify the holders
 Total Institutional Charges
 (Add all the charges together)
                                  =   L.$                 .              of the loans of the student’s withdrawal date.
                                                                         If Box Q is greater than Box R, proceed to Step 9.
M. Percentage of unearned Title IV aid
                                                                   STEP 9: Grant Funds to be Returned
    100% –                     %=     M.              .        %    S. Initial amount of Title IV grants for student to return
                      Box H
                                                                       From the initial amount of unearned Title IV aid due from
N. Amount of unearned charges                                          the student (Box Q) subtract the amount of loans to be
   Multiply institutional charges for the period (Box L) by            repaid by the student (Box R) .
   the percentage of unearned Title IV aid (Box M).
                                                                                     –                      =    S. $                      .
                x              %=
                                                                         Box Q                 Box R
                                      N. $                .        T. Amount of Title IV grant protection
     Box L            Box M                                           Multiply the total of Title IV grant aid that was disbursed
                                                                      and that could have been disbursed for the period
O. Amount for school to return
                                                                      (Box F) by 50%.
   Compare the amount of Title IV aid to be returned
   (Box K) to amount of unearned charges (Box N),                                    x 50% =                     T. $                      .
   and enter the lesser amount.
                                       O. $                .             Box F
                                                                    U. Title IV grant funds for student to return
STEP 6: Return of Funds by the School                                  From the Initial amount of Title IV grants for student to
                                                                       return (Box S) subtract the Amount of Title IV grant
The school must return the unearned aid for which the                  protection (Box T).
school is responsible (Box O) by repaying funds to the
following sources, in order, up to the total net amount                              –                      =    U. $                      .
disbursed from each source.                                              Box S                 Box T
                                              Amount for School        If Box U is less than or equal to zero, STOP. If not, go to Step 10.
             Title IV Programs                   to Return

1. Unsubsidized FFEL/Direct Stafford Loan                          STEP 10: Return of Grant Funds by the Student
2. Subsidized FFEL / Direct Stafford Loan                           Except as noted below, the student must return the unearned
                                                                    grant funds for which he or she is responsible (Box U). The grant
3. Perkins Loan                                                     funds returned by the student are applied to the following sources
4. FFEL/Direct PLUS (Graduate Student)                              in the order indicated, up to the total amount disbursed from that
5. FFEL / Direct PLUS (Parent)                                      grant program minus any grant funds the school is responsible for
                                                                    returning to that program in Step 6.
           Total loans the
         school must return           P. $                 .        Note that the student is not responsible for returning funds
                                                                    to any program to which the student owes $50.00 or less.
6. Pell Grant                                                           Title IV Grant Programs                         Amount To Return
7. Academic Competitiveness Grant                                    1. Pell Grant
8. National SMART Grant                                              2. Academic Competitiveness Grant
9. FSEOG                                                             3. National SMART Grant
10. TEACH Grant                                                      4. FSEOG
                                                                     5. TEACH Grant
                    You may use this form when the withdrawal date is on or after 11/01/2007                                         p. 2 of 3
                                                                            Treatment Of Title IV Funds When A Student Withdraws From A Credit-Hour Program


                          POST-WITHDRAWAL DISBURSEMENT TRACKING SHEET

Student’s Name                                                    Social Security Number

Date of school's determination that student withdrew                    /           /

I. Amount of Post-withdrawal Disbursement (PWD)

   Amount from “Box J” of the Treatment of Title IV Funds When a Student Withdraws worksheet                Box 1           $                 .
II. Outstanding Charges For Educationally Related Expenses Remaining On Student’s Account
Total Outstanding Charges Scheduled to be Paid from PWD
(Note: Prior-year charges cannot exceed $200.)
                                                                                                            Box 2           $             .

III. Post-withdrawal Disbursement Offered Directly to Student and/or Parent
From the total Post-withdrawal Disbursement due (Box 1), subtract the Post-withdrawal Disbursement to be credited to the student’s account
(Box 2) . This is the amount you must make to the student (grant) or offer to the student or parent (Loan) as a Direct Disbursement.

                       $               .          –     $               .                     =        $
                                                                                                            Box 3
                                                                                                                        .$                .
                               Box 1                           Box 2

IV. Allocation of Post-withdrawal Disbursement
                                Loan Amount       Loan Amount                               Loan Amount              Loan Amount          Title IV Aid
                                                                        Title IV Aid
                                School Seeks       Authorized                                  Offered                 Accepted           Disbursed
Type of Aid                                                              Credited
                                 to Credit to      to Credit to                               as Direct                as Direct          Directly to
                                                                        to Account
                                  Account            Account                                Disbursement             Disbursement          Student

Pell Grant                             N/A             N/A                                           N/A                N/A
ACG                                    N/A             N/A                                           N/A                N/A
National SMART Grant                   N/A             N/A                                           N/A                N/A
FSEOG                               N/A                N/A                                           N/A                 N/A
TEACH Grant                            N/A             N/A                                           N/A                N/A
Unsubsidized FFEL / Direct

Subsidized FFEL / Direct

Perkins

FFEL / Direct Grad Plus

FFEL / Direct Parent Plus

             Totals

V. Authorizations and Notifications

  Post-withdrawal disbursement loan notification sent to student and/or parent on                                /              /
  Deadline for student and/or parent to respond                     /           /
          Response received from student and/or parent on                           /        /                       Response not received
          School does not accept late response

VI. Date Funds Sent

  Date Direct Disbursement mailed or transferred                Grant                   /        /                   Loan             /             /
                  You may use this form when the withdrawal date is on or after 11/01/2007                                                        p. 3 of 3
   Treatment Of Title IV Funds When A Student Withdraws From A Clock-Hour Program
Student’s Name                                                                  Social Security Number
Date form
completed                 /              /                              Date of school’s determination
                                                                                 that student withdrew                          /             /
Period used for calculation (check one)                                 Payment period             Period of enrollment

                        Monetary amounts should be in dollars and cents (rounded to the nearest penny).
                When calculating percentages, round to three decimal places. (For example, .4486 = .449, or 44.9%)

STEP 1: Student’s Title IV Aid Information
                                                                                        Amount that Could
                                                                                                               E. Total Title IV aid disbursed for the
     Title IV Grant Programs                            Amount Disbursed               Have Been Disbursed        period.
1. Pell Grant                                                                                                             A.
2. Academic Competitiveness Grant                                                                                     +   B.
3. National SMART Grant
                                                                                                               = E. $                          .
4. FSEOG                                                                                                       F. Total Title IV grant aid disbursed and that
5. TEACH Grant                                                                                                    could have been disbursed for the
                                                                                                                  period.

                                               A.                               C.                                        A.
                                                             Subtotal                        Subtotal                 +   C.

         Title IV Loan Programs                        Net Amount Disbursed
                                                                                      Net Amount that Could
                                                                                      Have Been Disbursed
                                                                                                               =      F. $                     .
                                                                                                               G. Total Title IV aid disbursed and that could
6. Unsubsidized FFEL / Direct Stafford Loan                                                                       have been disbursed for the period.
7. Subsidized FFEL / Direct Stafford Loan
8. Perkins Loan                                                                                                           A.
9. FFEL/ Direct PLUS (Graduate Student)
                                                                                                                          B.
                                                                                                                          C.
10. FFEL / Direct PLUS (Parent)
                                                                                                                      +   D.
                                               B.                               D.                              =     G. $                     .
                                                           Subtotal                          Subtotal

STEP 2: Percentage of Title IV Aid Earned                                        STEP 4: Title IV Aid to be Disbursed or Returned
  Withdrawal date                              /              /                         If the amount in Box I is greater than the amount in
                                                                                        Box E, go to Post-withdrawal disbursement (Item J).
H. Determine the percentage of the period completed:
   Divide the clock hours scheduled to have been                                        If the amount in Box I is less than the amount in
   completed as of the withdrawal date in the period by                                 Box E, go to Title IV aid to be returned (Item K).
   the total clock hours in the period.                                                 If the amounts in Box I and Box E are equal, STOP.
                                                                                        No further action is necessary.
                                                                                     J. Post-withdrawal disbursement
                      ÷                            =              .         %           From the Amount of Title IV aid earned by the student
   Hours scheduled            Total hours in                                            (Box I) subtract the Total Title IV aid disbursed for the
     to complete                 period                                                 period (Box E). This is the amount of the post-
     If this percentage is greater than 60%, enter 100% in                              withdrawal disbursement.
     Box H and proceed to Step 3.                                                       Stop here, and enter the amount in Box 1 on Page 3
     If this percentage is less than or equal to 60%, enter                             (Post-withdrawal disbursement tracking sheet).
     that percentage in Box H,
     and proceed to Step 3.              H.                       .         %                           –                  = J.$                         .
                                                                                         Box I                Box E

STEP 3: Amount of Title IV Aid Earned by the Student                                 K. Title IV aid to be returned
Multiply the percentage of Title IV aid earned (Box H) by                               From the Total Title IV aid disbursed for the period
the Total Title IV aid disbursed and that could have been                               (Box E) subtract the Amount of Title IV aid earned by
disbursed for the period (Box G).                                                       the student (Box I) . This is the amount of Title IV aid
                                                                                        that must be returned.

             %x                        =       I.$                      .                               –                  =   K.$                       .
     Box H                Box G                                                         Box E                 Box I

   You may use this form when the withdrawal date is on or after 11/01/2007                                                                        p. 1 of 3
                                                                       Treatment Of Title IV Funds When A Student Withdraws From A Clock-Hour Program


Student’s Name                                                        Social Security Number

STEP 5: Amount of Unearned Title IV Aid Due                           STEP 8: Repayment of the Student’s loans
             from the School
                                                                        From the Net loans disbursed to the student (Box B)
L. Institutional charges            Tuition                             subtract the Total loans the school must return (Box P)
   for the period                   Room                                to find the amount of Title IV loans the student is still
                                                                        responsible for repaying (Box R).
                                    Board
                                                                        These outstanding loans consist either of loan funds the
                                     Other
                                                                        student has earned, or unearned loan funds that the
                                     Other                              school is not responsible for repaying, or both; and they
                                     Other                              are repaid to the loan holders according to the terms of
                                                                        the borrower’s promissory note.
Total Institutional Charges
(Add all the charges together)     = L.$                   .                           –                      = R.$
                                                                          Box B                  Box P
M. Percentage of unearned Title IV aid
                                                                           If Box Q is less than or equal to Box R, STOP.
   100% –                     % =      M.              .       %           The only action a school must take is to notify the
                      Box H                                                holders of the loans of the student’s withdrawal date.
N. Amount of unearned charges                                              If Box Q is greater than Box R, proceed to Step 9.
   Multiply institutional charges for the period (Box L) by the
   Percentage of unearned Title IV aid (Box M).                       STEP 9: Grant Funds to be Returned

                x                % = N.$              .               S. Initial amount of Title IV grants for student to return
                                                                         From the Initial amount of unearned Title IV aid due from
    Box L               Box M
                                                                         the student (Box Q) subtract the amount of loans to be
                                                                         repaid by the student (Box R) .
O. Amount for school to return
   Compare the amount of Title IV aid to be returned
   (Box K) to Amount of unearned charges (Box N),                                      –                      =    S.                     .
   and enter the lesser amount.                                            Box Q                Box R

                                       O.$            .               T. Amount of Title IV grant protection
                                                                         Multiply the total of Title IV grant aid that was disbursed
                                                                         and that could have been disbursed for the period
STEP 6: Return of Funds by the School                                    (Box F) by 50%.
The school must return the unearned aid for which the
school is responsible (Box O) by repaying funds to the                                 x 50% =                     T.                     .
following sources, in order, up to the total net amount                    Box F
disbursed from each source.                  Amount for School
                                                 to Return
                                                                      U. Title IV grant funds for student to return
          Title IV Programs                                             From the Initial amount of Title IV grants for student to
1. Unsubsidized FFEL/Direct Stafford Loan                               return (Box S) subtract the Amount of Title IV grant
2. Subsidized FFEL / Direct Stafford Loan                               protection (Box T).
3. Perkins Loan                                                                        –                      =    U.                     .
4. FFEL/Direct PLUS (Graduate Student)                                     Box S                Box T
5. FFEL / Direct PLUS (Parent)                                          If Box U is less than or equal to zero, STOP. If not, go to Step 10.
              Total loans the
            school must return    =    P. $                 .         STEP 10: Return of Grant Funds by the Student
6. Pell Grant                                                         Except as noted below, the student must return the unearned grant
7. Academic Competitiveness Grant                                     funds for which he or she is responsible (Box U). The grant funds
                                                                      returned by the student are applied to the following sources in the
8. National SMART Grant                                               order indicated, up to the total amount disbursed from that grant
9. FSEOG                                                              program minus any grant funds the school is responsible for
                                                                      returning to that program in Step 6.
10. TEACH Grant
                                                                      Note that the student is not responsible for returning funds to
                                                                      any program to which the student owes $50.00 or less.
STEP 7: Initial Amount of Unearned Title IV Aid                            Title IV Grant Programs                        Amount To Return
             Due from the Student
                                                                         1. Pell Grant
From the amount of Title IV aid to be returned (Box K) subtract
                                                                         2. Academic Competitiveness Grant
the Amount for the school to return (Box O).
                                                                         3. National SMART Grant
                –                  =   Q.$                               4. FSEOG
    Box K              Box O
                                                                         5. TEACH Grant
      If Box Q is ≤ zero, STOP. If greater than zero, go to Step 8.

                        You may use this form when the withdrawal date is on or after 11/01/2007 p. 2 of 3
                                                                            Treatment Of Title IV Funds When A Student Withdraws From A Clock-Hour Program


                          POST-WITHDRAWAL DISBURSEMENT TRACKING SHEET

Student’s Name                                                    Social Security Number

Date of school's determination that student withdrew                    /          /

I. Amount of Post-withdrawal Disbursement (PWD)

   Amount from “Box J” of the Treatment of Title IV Funds When a Student Withdraws worksheet               Box 1           $                 .
II. Outstanding Charges For Educationally Related Expenses Remaining On Student’s Account
Total Outstanding Charges Scheduled to be Paid from PWD
(Note: Prior-year charges cannot exceed $200.)
                                                                                                           Box 2           $             .

III. Post-withdrawal Disbursement Offered Directly to Student and/or Parent
From the total Post-withdrawal Disbursement due (Box 1), subtract the Post-withdrawal Disbursement to be credited to the student’s account
(Box 2) . This is the amount you must make to the student (grant) or offer to the student or parent (Loan) as a Direct Disbursement.

                       $               .          –     $               .                    =         $
                                                                                                           Box 3
                                                                                                                       .$                .
                               Box 1                           Box 2

IV. Allocation of Post-withdrawal Disbursement
                                Loan Amount       Loan Amount                               Loan Amount             Loan Amount          Title IV Aid
                                                                        Title IV Aid
                                School Seeks       Authorized                                  Offered                Accepted           Disbursed
Type of Aid                                                              Credited
                                 to Credit to      to Credit to                               as Direct               as Direct          Directly to
                                                                        to Account
                                  Account            Account                                Disbursement            Disbursement          Student

Pell Grant                             N/A             N/A                                          N/A                N/A
ACG                                    N/A             N/A                                          N/A                N/A
National SMART Grant                   N/A             N/A                                          N/A                N/A
FSEOG                               N/A                N/A                                          N/A                 N/A
TEACH Grant                            N/A             N/A                                          N/A                N/A
Unsubsidized FFEL / Direct

Subsidized FFEL / Direct

Perkins

FFEL / Direct Grad Plus

FFEL / Direct Parent Plus

             Totals

V. Authorizations and Notifications

  Post-withdrawal disbursement loan notification sent to student and/or parent on                               /              /
  Deadline for student and/or parent to respond                     /          /
          Response received from student and/or parent on                          /        /                       Response not received
          School does not accept late response

VI. Date Funds Sent

  Date Direct Disbursement mailed or transferred                Grant                  /        /                   Loan             /             /
                  You may use this form when the withdrawal date is on or after 11/01/2007                                                       p. 3 of 3
                              Information Required when Referring
                     Student Overpayments to Borrower Services - Collections
                                                               Student Information

Name (Last, First, MI):                                                      Address:

Telephone Number:

Social Security Number:                                                      Date of Birth:

If the overpayment includes an Academic Competitiveness, National Smart Grant, or TEACH Grant, enter the Award Identifier (ID) used when the
award was created in COD.
ACG Award ID:                                                                National Smart Grant Award ID:
TEACH Award ID:

                                                          Parent/Spouse Information
Name (Last, First, MI):                                                       Address:

Telephone Number:

                                                                School Information
           If your Pell Reporting ID is different than your Pell Attended ID, please provide both. Otherwise, just report the Pell Attended ID.

Reporting School’s Pell ID Number:                                            Attending School’s Pell ID Number:

If your school does not have a Pell ID, Enter your OPE ID:

Name of Contact:                                                              Telephone Number:

                                                      Disbursements and Repayments
                                                                              Academic            National
                                                           Pell Grant       Competitiveness        Smart              FSEOG 1             TEACH
                                                                                Grant              Grant                                   Grant
Award year in which overpayment was disbursed:

Total grant disbursed:

Dates of disbursement:
(Must match NSLDS overpayment record)

Overpayment amount owed by student *

Total grant repaid by student to school, if any:

Date of last payment to school, if any:
                                                                                                                                 1
Total being referred for collection:
                                             1
                                                 If using individual or aggregate matching, report federal share only. Otherwise report total FSEOG.


* If the overpayment is the result of a withdrawal, provide the date of the withdrawal                /         /
  If the overpayment is not the result of a withdrawal, please provide a brief explanation of the reason for the overpayment.




                          SEND INFORMATION TO                  Student Loan Processing Center-Overpayments
                                                               P.O. Box 4157
               (903) 454-5398                      FAX         Greenville, Texas 75403
                       ECONOMIC HARDSHIP DEFERMENT REQUEST                                                                                                              OMB No. 1845-0005
                                                                                                                                                                        Form Approved
                       Federal Family Education Loan Program                                                                                                            Exp. Date 05/31/2012
                       Use this form only if all of your outstanding Federal Family Education Loan Program loans were made on or after July 1, 1993, or if you had no
                       balance on loans made before July 1, 1993, when you obtained a loan disbursed on or after July 1, 1993.
                       WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents is subject to
      HRD              penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.

SECTION 1: BORROWER IDENTIFICATION
                                                                                                       Please enter or correct the following information.
                                                                                                       SSN |__|__|__|-|__|__|-|__|__|__|__|
                                                                                                       Name
                                                                                                       Address
                                                                                                       City, State, Zip Code
                                                                                                       Telephone - Home (        )
                                                                                                       Telephone - Other (       )
                                                                                                       E-mail Address (Optional)
SECTION 2: DEFERMENT REQUEST
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 4, 5, and 6.
 I meet the qualifications stated in Section 6 for the Economic Hardship Deferment checked below and request that my loan holder defer repayment of my loan(s) beginning
      |__|__|-|__|__|-|__|__|__|__|. (You must provide this date regardless of which condition you check below.)
      To qualify, I must meet one of the conditions listed below and must provide the required documentation, as described in Section 6, for only that condition.
Check one:
(1)       I have been granted an economic hardship deferment under the William D. Ford Federal Direct Loan (Direct Loan) Program or the Federal Perkins Loan Program for the same
          period of time for which I am requesting this deferment. I have attached documentation of the deferment.
(2)       I am receiving or received payments under a federal or state public assistance program, such as Temporary Assistance for Needy Families (TANF), Supplemental Security
          Income (SSI), Food Stamps, or state general public assistance. I have attached documentation of these payments.
(3)       I am serving as a Peace Corps volunteer. I have attached documentation certifying my period of service in the Peace Corps.
(4)       I work full time and my monthly income does not exceed the larger of (A) the Federal Minimum Wage Rate or (B) 150% of the poverty guideline for my family size and state. I
          have attached documentation of this income.
          My monthly income (as defined in Section 5) is $ ____________.               My family size (as defined in Section 5) is ____________.
          (A) Federal Minimum Wage Rate (monthly amount, based on $7.25 an hour): $1,256.67
          (B) 150% of the poverty guideline for my family size and state: This amount is listed in Section 6.

SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
 I understand that:
      (1) I am not required to make payments of loan principal during my deferment. Interest will not be charged on my subsidized loan(s) during my deferment. However, interest will
          be charged on my unsubsidized loan(s).
      (2) I have the option of paying the interest that accrues on my unsubsidized loan(s) during my deferment.
      (3) I may choose to make interest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period.
             I wish to make interest payments on my unsubsidized loan(s) during my deferment.
      (4) My deferment will begin on the date the deferment condition began.
      (5) My deferment will end on the earlier of the date that the condition that establishes my deferment eligibility ends or the certified deferment end date.
      (6) My maximum cumulative eligibility for an economic hardship deferment is 36 months. Except for a deferment based on condition (3), as described in Section 2, I must reapply
          every 12 months if I continue to meet the criteria for an economic hardship deferment.
      (7) If my deferment does not cover all my past due payments, my loan holder may grant me a forbearance for all payments due before the begin date of my deferment. If the
          period for which I am eligible for a deferment has ended, my loan holder may grant me a forbearance for all payments due at the time my deferment request is processed.
      (8) My loan holder may grant me a forbearance on my loans for up to 60 days, if necessary, for the collection and processing of documentation related to my deferment request.
          Interest that accrues during this forbearance will not be capitalized.
 I certify that: (1) The information I provided in Sections 1 and 2 above is true and correct. (2) I will provide additional documentation to my loan holder, as required, to support my
   deferment status. (3) I will notify my loan holder immediately when the condition that qualified me for the deferment ends. (4) I have read, understand, and meet the eligibility
   criteria of the deferment for which I have applied, as explained in Section 6.
 I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to contact me regarding my loan(s), including repayment of my
   loan(s), at the current or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded
   voice or text messages.


Borrower’s Signature                                                                                                                               Date




                                                                                            Page 1 of 3
SECTION 4: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Report dates as month-day-year (MM-DD-YYYY). For example, ‘January 31, 2009’ = ‘01-31- 2009’. Include your name and social security number
(SSN) on any documentation that you are required to submit with this form. If you need help completing this form, contact your loan holder.
Return the completed form and any required documentation to the address shown in Section 7.
SECTION 5: DEFINITIONS
 Capitalization is the addition of unpaid interest to the principal balance of my loan. The principal balance of a loan increases when payments are postponed during periods of
  deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more
  payments may be required. The chart below provides estimates, for a $15,000 unsubsidized loan balance at a 9% interest rate, of the monthly payments due following a 12-month
  deferment. It compares the effects of paying the interest as it accrues, capitalizing the interest at the end of the deferment, and capitalizing interest quarterly and at the end of the
  deferment. My actual loan interest cost will depend on my interest rate, length of the deferment, and frequency of capitalization. Paying interest during the period of deferment
  lowers the monthly payment by about $18 and saves about $772 over the lifetime of the loan, as depicted in the chart below.
             Treatment of Interest Accrued                   Loan         Capitalized Interest      Principal to      Monthly         Number of Total Amount            Total Interest
                     During Deferment                       Amount           for 12 Months           Be Repaid        Payment         Payments          Repaid               Paid
      Interest is paid                                    $15,000.00              $0.00              $15,000.00       $190.01            120          $24,151.64*          $9,151.64
      Interest is capitalized at the end of deferment     $15,000.00            $1,350.00            $16,350.00       $207.11            120          $24,853.79           $9,853.79
      Interest is capitalized quarterly during
                                                          $15,000.00            $1,396.25            $16,396.25       $207.70            120          $24,924.09           $9,924.09
      deferment and at the end of deferment
  *Total amount repaid includes $1,350 of interest paid during the 12-month period of deferment.
 A deferment is a period during which I am entitled to postpone repayment of the principal balance of my loan(s). The federal government pays the interest that accrues during an
  eligible deferment for all subsidized Federal Stafford Loans and for Federal Consolidation Loans for which the Consolidation Loan application was received by my loan holder (1)
  on or after January 1, 1993, but before August 10, 1993, (2) on or after August 10, 1993, if it includes only Federal Stafford Loans that were eligible for federal interest subsidy, or
  (3) on or after November 13, 1997, for that portion of the Consolidation Loan that paid a subsidized FFEL Program loan or a subsidized Federal Direct Loan. I am responsible for
  the interest that accrues during this period on all other FFEL Program loans.
 Family size is determined by counting (1) myself, (2) my spouse, (3) my children, including unborn children who will be born during the period covered by the deferment, if they
  receive more than half of their support from me, and (4) other people if, at the time I request this deferment, they live with me, receive more than half their support from me, and will
  continue to receive this support from me for the year that I certify my family size. Support includes money, gifts, loans, housing, food, clothes, car, medical and dental care, and
  payment of college costs.
 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal Supplemental Loans for Students (SLS),
  Federal PLUS Loans, Federal Consolidation Loans, Guaranteed Student Loans (GSL), Federal Insured Student Loans (FISL), and Auxiliary Loans to Assist Students (ALAS).
 The Federal Perkins Loan (Perkins Loan) Program includes Federal Perkins Loans, National Direct Student Loans (NDSL), and National Defense Student Loans (Defense
  Loan).
 Forbearance means permitting the temporary cessation of payments, allowing for an extension of time for making payments, or temporarily accepting smaller payments than
  previously scheduled. I am responsible for the interest that accrues on my loan(s) during a forbearance. If I do not pay the interest that accrues, the interest may be capitalized.
 Full-time employment is defined as working at least 30 hours per week in a position expected to last at least 3 consecutive months.
 The holder of my FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the U.S. Department of Education.
 Monthly income is either:
  (1) the amount of my monthly income from employment and other sources before taxes and other deductions, or
  (2) one-twelfth of the amount of my income reported as “adjusted gross income” on my most recently filed Federal Income Tax Return.
  I may choose either of these income amounts for the purpose of reporting my monthly income on this deferment request.
 The William D. Ford Federal Direct Loan (Direct Loan) Program includes Federal Direct Stafford/Ford (Direct Subsidized) Loans, Federal Direct Unsubsidized Stafford/Ford
  (Direct Unsubsidized) Loans, Federal Direct PLUS (Direct PLUS) Loans, and Federal Direct Consolidation (Direct Consolidation) Loans. These loans are known collectively as
  “Direct Loans.”
SECTION 6: ELIGIBILITY CRITERIA FOR ECONOMIC HARDSHIP DEFERMENT
 If I had no outstanding balance on a FFEL Program loan as of the date I obtained a loan on or after July 1, 1993, I may defer repayment of my loan(s) during the period that I
   meet one of the economic hardship deferment conditions described in Section 2.
 If my economic hardship deferment eligibility is based on condition (1), as described in Section 2, I must provide my loan holder with documentation of the deferment that has been
   granted under the Direct Loan Program or the Federal Perkins Loan Program (for example, correspondence from my loan holder showing that I have been granted a deferment).
 If my economic hardship deferment eligibility is based on condition (2), as described in Section 2, I must provide my loan holder with documentation confirming that I am receiving
   or received payments under a federal or state public assistance program.
 If my economic hardship deferment eligibility is based on condition (3), as described in Section 2, I must provide my loan holder with documentation which certifies the beginning
   and anticipated ending dates of my service in the Peace Corps and which is signed and dated by an authorized Peace Corps official.
 If my economic hardship deferment eligibility is based on condition (4), as described in Section 2, I must provide my loan holder with documentation of my monthly income as
   defined in Section 5. If I am reporting monthly income from employment and other sources, I must provide documentation such as pay stubs. If I am reporting one-twelfth of my
   adjusted gross income, I must provide a copy of my most recently filed Federal Income Tax Return.
 If my economic hardship deferment eligibility is based on condition (4), I must use the applicable amount based on my family size and state as shown in the chart below. If I am not
   currently residing in the United States, I will use the amount for the 48 contiguous states and the District of Columbia.
                                                                                  These monthly amounts represent 150% of the poverty guideline
                                     Borrower’s Family Size
                                   (See definition in Section 5)            48 Contiguous States and
                                                                                                                Alaska                  Hawaii
                                                                               District of Columbia
                                                 1                                 $1,353.75                 $1,691.25             $1,557.50
                                                 2                                   1,821.25                 2,276.25               2,095.00
                                                 3                                   2,288.75                 2,861.25               2,632.50
                                                 4                                   2,756.25                 3,446.25               3,170.00
                                  For each additional person, add:                     467.50                   585.00                 537.50




                                                                                      Page 2 of 3
SECTION 7: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST
Return the completed deferment request and any required documentation to:                         If you need help completing this form, call:
(If no address is shown, return to your loan holder.)                                             (If no telephone number is shown, call your loan holder.)




SECTION 8: IMPORTANT NOTICES
Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §421 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and the
authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family
Education Loan Program (FFELP) and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
(such as a deferment, forbearance, discharge, or forgiveness) under the FFELP, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and
report on your loan(s) if your loan(s) becomes delinquent or in default. We also use your SSN as an account identifier and to permit you to access your account information
electronically.
The information in your file may be disclosed, on a case-by-case basis or under a computer matching program, to third parties as authorized under routine uses in the appropriate
systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local agencies, to private parties such as relatives,
present and former employers, business and personal associates, to consumer reporting agencies, to financial and educational institutions, and to guaranty agencies in order to verify
your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s), to investigate
possible fraud and to verify compliance with federal student financial aid program regulations, or to locate you if you become delinquent in your loan payments or if you default. To
provide default rate calculations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history
information, disclosures may be made to educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal or state agencies. To provide a standardized method for educational institutions to efficiently submit student enrollment
status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in repayment efforts, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to the
litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate authority for action. We may send
information to members of Congress if you ask them to help you with federal student aid questions. In circumstances involving employment complaints, grievances, or disciplinary
actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective bargaining agreement, we may disclose records to a labor organization
recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for the purpose of performing any programmatic function that requires disclosure of records.
Before making any such disclosure, we will require the contractor to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act
safeguards.
Paperwork Reduction Notice
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The
valid OMB control number for this information collection is 1845-0005. The time required to complete this information collection is estimated to average 0.16 hours (10 minutes) per
response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and complete and review the information collection. If you
have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, DC 20202-4537
If you have questions regarding the status of your individual submission of this form, write directly to the address shown in Section 7.




                                                                                        Page 3 of 3
                       SOLICITUD DE APLAZAMIENTO DE PAGO:                                                                                                                      N.o de OMB: 1845-0005
                                                                                                                                                                               Formulario aprobado

                       DIFICULTADES ECONÓMICAS                                                                                                                                 Caduca: 31 mayo 2012

                       Federal Family Education Loan ProgramSM
                       Sólo utilice el presente formulario si se hicieron el 1 de julio de 1993 o posterior todos los préstamos que obtuvo mediante el programa de préstamos
      HRD              educativos Federal Family Education Loan Program (FFELSM) y que están pendientes de pago, o si usted no tenía, en el momento de obtener algún
                       préstamo que se desembolsó el 1 de julio de 1993 o posterior, ningún saldo insoluto en préstamos hechos antes del 1 de julio de 1993.
                       AVISO: El que a sabiendas haga declaraciones falsas o engañosas en el presente formulario, o en cualquier documento adjunto al mismo, quedará
                       sujeto a sanciones, las cuales pueden incluir las multas, el encarcelamiento o ambas penas, de conformidad con el Código Penal de EE.UU. y con la
                       Sección 1097 del Título 20 del Código de Estados Unidos.

SECCIÓN 1: DATOS PERSONALES DEL PRESTATARIO
                                                                                                         Favor de introducir o corregir la siguiente información:
                                                                                                         N.o de Seguro Social
                                                                                                         Nombre y apellido
                                                                                                         Dirección
                                                                                                         Ciudad, estado, código postal
                                                                                                         Teléfono (domicilio) (     )
                                                                                                         Teléfono (alternativo) (      )
                                                                                                         Correo electrónico (opcional)
SECCIÓN 2: SOLICITUD DE APLAZAMIENTO DE PAGO
Antes de responder a las preguntas, lea todo el formulario detenidamente, incluyendo las indicaciones y otra información que se hallan en las Secciones 4, 5 y 6.
      Cumplo con los requisitos, estipulados en la Sección 6, para acogerme al aplazamiento de pago por el motivo indicado abajo, y solicito que mi acreedor aplace el pago de mis
      préstamos a partir del                                      . (Es obligatorio indicar esta fecha, sin importar cuál de las condiciones se escoja abajo.)
      Para acogerme al aplazamiento del pago, debo cumplir con por lo menos una de las siguientes condiciones y aportar, conforme a lo estipulado en la Sección 6, la documentación
      justificativa de esa condición únicamente.
Marque sólo una de las casillas siguientes:
(1)       Me han otorgado, al amparo del programa de préstamos educativos William D. Ford Federal Direct Loan ProgramSM o del Programa Federal de Préstamos Perkins, un
          aplazamiento de pago por motivos de dificultades económicas, el que tiene vigencia durante el mismo período en que la tendría el aplazamiento que solicito mediante el presente
          formulario. Adjunto constancia del aplazamiento de pago existente.
(2)       He recibido o recibo actualmente subsidios al amparo de algún programa de asistencia pública administrado por los correspondientes organismos federales o del estado
          donde resido, como por ejemplo, el Programa de Ayuda Temporal para Familias Necesitadas (TANF), el Programa de Ingreso Suplementario del Seguro Social (SSI), el
          Programa de Cupones para Alimentos o un programa general de asistencia social administrado por el estado correspondiente. Adjunto constancia de los subsidios.
(3)       Presto servicio como voluntario en el Cuerpo de Paz. Adjunto constancia del período de servicio en el Cuerpo de Paz.
(4)       Trabajo a tiempo completo, y mis ingresos mensuales no superan la mayor de las cantidades siguientes: (A) el ingreso mensual obtenido a razón del salario mínimo federal o (B)
          el 150 por ciento del ingreso mensual que constituye el umbral de pobreza que corresponde al tamaño de mi hogar y al estado donde resido. Adjunto constancia de mis
          ingresos.
          Mis ingresos mensuales (según lo definido en la Sección 5) son de $ __________.                     Mi hogar (según lo definido en la Sección 5) tiene __________ personas.
          (A) Salario mínimo federal (suma mensual, a razón de $7.25 por hora): $1,256.67
          (B) 150% del umbral de pobreza que corresponde al tamaño de mi hogar y al estado donde resido: Esta cantidad se encuentra en la Sección 6.
SECCIÓN 3: ACEPTACIÓN, CERTIFICACIÓN Y AUTORIZACIÓN DEL PRESTATARIO
      Entiendo y acepto lo siguiente:
      (1) No tengo obligación de efectuar pagos al capital del préstamo durante la vigencia del aplazamiento de pago. Durante este período, no se me cobrarán los intereses
          producidos por mis préstamos que tengan subsidio del interés. Sin embargo, se me cobrarán los intereses producidos por mis préstamos que no tengan subsidio del interés.
      (2) Tengo la opción de pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
      (3) Puedo optar por pagar el interés, marcando la casilla de abajo. Mi acreedor podrá capitalizar los intereses que no se paguen durante el período de aplazamiento.
             Deseo pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
      (4) El aplazamiento de pago entrará en vigor en la fecha de inicio de la condición que justificó el otorgamiento de tal beneficio.
      (5) El aplazamiento de pago vencerá en la primera de las dos fechas siguientes: la fecha en que termine la condición que justificó el otorgamiento de tal beneficio o la fecha en
          que venza el período certificado de aplazamiento de pago.
      (6) La duración máxima acumulada del aplazamiento de pago otorgado por motivos de dificultades económicas, es de 36 meses. Salvo que se trate del tipo de aplazamiento de
          pago otorgado a base de la condición (3), según lo descrito en la Sección 2, debo volver a solicitar el aplazamiento cada 12 meses, en caso de seguir cumpliendo con los
          requisitos correspondientes.
      (7) Si el aplazamiento de pago no abarca todas las cuotas atrasadas, mi acreedor puede concederme un período de indulgencia de morosidad que abarque las que hayan
          vencido antes de la fecha de entrada en vigor del aplazamiento. En caso de que haya terminado el período de vigencia del aplazamiento, mi acreedor puede otorgarme un
          período de indulgencia que abarque toda cuota que haya vencido hasta la fecha de tramitación de la presente solicitud.
      (8) Mi acreedor puede concederme, según sea necesario, un período de indulgencia de morosidad por una duración máxima de 60 días, por motivo de la recopilación y
          tramitación de los documentos relativos a mi solicitud de aplazamiento de pago. No se capitalizarán los intereses producidos durante el plazo de vigencia de este tipo de
          indulgencia.
                                                                                         Continúa en la página 2



                                                                                             Página 1 de 4
SECCIÓN 3: ACEPTACIÓN, CERTIFICACIÓN Y AUTORIZACIÓN DEL PRESTATARIO (CONTINUACIÓN)
   Certifico lo siguiente: (1) que la información que proporcioné en las Secciones 1 y 2, arriba, es correcta y verídica; (2) que aportaré documentación complementaria a mi
   acreedor, según sea necesario, que acredite las circunstancias en cuya virtud me acojo al aplazamiento de pago; (3) que avisaré a mi acreedor, de forma inmediata, una vez que
   hayan terminado la condición que justificó el aplazamiento de pago, y (4) que he leído, entendido y cumplido los requisitos y condiciones cuya satisfacción es necesaria para la
   concesión del aplazamiento de pago por los motivos señalados en el presente formulario de solicitud, según lo expuesto en la Sección 6.
   Autorizo a la institución educativa, al acreedor, al garante, al Departamento y a sus respectivos agentes y contratistas a comunicarse conmigo respecto a mis préstamos, incluido
   el pago de los mismos, al número actual o futuro (si lo proporciono) de mi teléfono móvil u otro dispositivo inalámbrico, por medio de sistemas de marcado automático, mensajes
   de texto o mensajes de voz artificial o grabados.

Firma del prestatario                                                                                                                 Fecha

SECCIÓN 4: INSTRUCCIONES PARA LLENAR EL FORMULARIO
Escriba sus respuestas a máquina o con letra de molde y tinta oscura. Escriba las fechas en el formato mes-día-año (MM-DD-AAAA). Por ejemplo, «31 de enero de 2009» equivale
a «01-31-2009». Incluya su nombre, apellido y número de Seguro Social en cualquier documento que deba presentarse con el presente formulario. Si usted necesita ayuda para
llenar el formulario, comuníquese con su acreedor.
Remita el formulario con los datos completos, y cualquier documentación solicitada, a la dirección indicada en la Sección 7.
SECCIÓN 5: DEFINICIONES
  El acreedor de mis préstamos del Programa FFEL puede ser una entidad prestamista, garante o financiera (del mercado secundario), o el Departamento de Educación de EE.UU.
  El aplazamiento de pago consiste en un período durante el cual tengo derecho a posponer el pago del capital de mis préstamos. El Departamento de Educación de EE.UU.
  sufraga los intereses producidos durante el aplazamiento de pago debidamente tramitado, todo Préstamo Federal Stafford con subsidio del interés y todo Préstamo Federal de
  Consolidación cuya solicitud llegó a mi acreedor (1) el 1 de enero de 1993 o posterior pero antes del 10 de agosto de 1993, (2) el 10 de agosto de 1993 o posterior, siempre que la
  solicitud incluyera sólo los Préstamos Federales Stafford que gozaban del subsidio federal del interés, o (3) el 13 de noviembre de 1997 o posterior, cuando se trate de la porción
  del préstamo de consolidación con la que se liquidó un préstamo educativo con subsidio del interés obtenido del Programa FFEL o del Direct Loan Program. Tengo la
  responsabilidad de pagar los intereses producidos durante este período por cualquier otro préstamo hecho al amparo del Programa FFEL.
  La capitalización consiste en añadir los intereses pendientes de pago al saldo de capital del préstamo. El saldo de capital del préstamo aumenta cuando se postergan los pagos,
  durante los períodos de aplazamiento de pago o de indulgencia de morosidad, y se capitalizan los intereses. Como resultado de esto, puede que se produzcan más intereses
  durante la vigencia del préstamo, que se aumente la cantidad de la cuota mensual o que se incremente el número de los pagos. En el cuadro siguiente, se presentan cálculos
  aproximados de las cuotas mensuales de un préstamo sin subsidio del interés, hecho por un monto de $15,000 y con una tasa de 9 por ciento, después de un período de aplaza-
  miento de pago de 12 meses de duración. Se comparan los efectos de las diferentes maneras de tratar los intereses del préstamo: pagarlos a medida que se van produciendo,
  capitalizarlos al final del período de aplazamiento de pago y capitalizarlos trimestralmente y al final del período de aplazamiento de pago. El costo efectivo de los intereses de mi
  préstamo dependerá de la tasa de interés, de la duración del aplazamiento de pago y de la frecuencia de capitalización de los intereses. Como se puede apreciar en el cuadro, si
  los intereses se van pagando durante el período del aplazamiento de pago, la cuota mensual se rebaja en unos $18 y se ahorran casi $772 durante la vigencia del préstamo.
       Tratamiento de los intereses producidos         Cantidad del       Intereses capitalizados       Capital a        Cuota        Número                         Total pagado
                                                                                                                                                   Total pagado
             durante el aplazamiento de pago            préstamo                (12 meses)               pagar          mensual      de cuotas                       en intereses
      Pagar los intereses durante
                                                        $15,000.00                 $0.00               $15,000.00       $190.01          120        $24,151.64*        $9,151.64
      el aplazamiento de pago
      Capitalizar los intereses al final
                                                        $15,000.00               $1,350.00             $16,350.00       $207.11          120         $24,853.79        $9,853.79
      del aplazamiento de pago
      Capitalizar los intereses cada
       trimestre durante el aplazamiento                $15,000.00               $1,396.25             $16,396.25       $207.70          120         $24,924.09        $9,924.09
      de pago y al final del mismo
   * El total pagado incluye los $1,350 de intereses pagados durante los 12 meses del aplazamiento de pago.
  Empleo a tiempo completo se define como el trabajar por lo menos 30 horas semanales en una plaza que se prevé que dure como mínimo tres meses consecutivos.
  Indulgencia de morosidad se refiere a la suspensión temporal de las cuotas del préstamo, a la prolongación del plazo de vencimiento de las cuotas o a la reducción temporal de
  la cantidad programada de las cuotas. Tengo la responsabilidad de pagar los intereses producidos por mis préstamos durante el período de indulgencia de morosidad. Si no pago
  los intereses, éstos pueden capitalizarse.
  El ingreso mensual consiste en uno de las cantidades siguientes:
  (1) la suma de mis ingresos mensuales, obtenidos por concepto del trabajo y de otras fuentes, antes de que se deduzcan de los mismos los impuestos y otros descuentos, o bien,
  (2) una duodécima parte de los ingresos mensuales que anoté como «ingreso bruto ajustado» en la declaración más reciente de impuesto federal sobre los ingresos.
  Puedo emplear cualquiera de estas cantidades para efectos de declarar mi ingreso mensual en el presente formulario.
  El Federal Family Education Loan Program (Programa FFEL) incluye los Préstamos Federales Stafford (con y sin subsidio del interés), los Préstamos Federales
  Suplementarios para Estudiantes (SLS), los Préstamos Federales PLUS, los Préstamos Federales de Consolidación, Préstamos Estudiantiles Garantizados (GSL), Préstamos
  Federales Estudiantiles Asegurados (FISL) y Préstamos Auxiliares de Asistencia para Estudiantes (ALAS).
  El Programa Federal de Préstamos Perkins incluye los Préstamos Federales Perkins, Préstamos Nacionales Directos para Estudiantes (NDSL) y Préstamos Educativos para la
  Defensa Nacional.
  En el tamaño del hogar se incluyen las siguientes personas: (1) yo mismo; (2) mi cónyuge; (3) mis hijos (incluidos los hijos aún no nacidos si nacerán durante el período del
  aplazamiento de pago), siempre que reciban más de la mitad del sustento de mi parte, y (4) otras personas si, a la fecha de la solicitud del aplazamiento, reciben de mi parte más
  de la mitad del sustento y continuarán recibiéndolo durante el año correspondiente al cálculo del tamaño de mi hogar. El sustento incluye dinero, donaciones, préstamos,
  hospedaje, alimentos, ropa, pago de gastos de automóvil, atención médica y odontológica, y pago de gastos de estudios superiores.
  El programa de préstamos educativos William D. Ford Federal Direct Loan Program incluye los Préstamos Federales Stafford/Ford (préstamos con subsidio del interés del
  Direct Loan Program), Préstamos Federales Stafford/Ford sin subsidio del interés (préstamos sin subsidio del interés del Direct Loan Program), Préstamos Federales PLUS
  (Préstamos PLUS del Direct Loan Program) y Préstamos de Consolidación (Préstamos de Consolidación del Direct Loan Program). Los préstamos educativos anteriores se
  conocen en su conjunto como «Direct LoansSM».




                                                                                  Página 2 de 4
SECCIÓN 6: REQUISITOS PARA ACOGERSE AL APLAZAMIENTO DE PAGO POR DIFICULTADES ECONÓMICAS
 Si, a la fecha de haber obtenido un préstamo el 1 de julio de 1993 o posterior, no tenía ningún saldo pendiente de pago en préstamos hechos mediante el Programa FFEL,
 puedo acogerme al aplazamiento de pago de mis préstamos durante el período de mi cumplimiento de alguna de las condiciones relativas a las dificultades económicas indicadas
 en la Sección 2.
 Si solicito el aplazamiento de pago basándome en la condición (1), según lo descrito en la Sección 2, deberé aportar a mi acreedor constancia de la concesión del aplazamiento
 de pago al amparo del programa de préstamos educativos Direct Loan Program o del Programa Federal de Préstamos Perkins (por ejemplo, una carta recibida del acreedor
 correspondiente en la que se exponga la concesión del aplazamiento).
 Si solicito el aplazamiento de pago basándome en la condición (2), según lo descrito en la Sección 2, deberé aportar a mi acreedor constancia de que he recibido o recibo
 actualmente subsidios al amparo de algún programa asistencial administrado por un organismo federal o del estado correspondiente.
 Si solicito el aplazamiento de pago basándome en la condición (3), según lo descrito en la Sección 2, deberé aportar a mi acreedor constancia de la fecha de inicio y de la fecha
 prevista de terminación de mi servicio en el Cuerpo de Paz, debidamente firmada por un funcionario autorizado de dicho organismo.
 Si solicito el aplazamiento de pago basándome en la condición (4), según lo descrito en la Sección 2, deberé aportar a mi acreedor constancia de mi ingreso mensual, conforme a
 lo definido en la Sección 5. Si declaro los ingresos mensuales que percibo por concepto del trabajo y de otras fuentes, deberé facilitar la documentación adecuada, como por
 ejemplo, los talones de pago. Si declaro una duodécima parte de mi ingreso bruto ajustado, deberé aportar copia de mi declaración más reciente de impuesto federal sobre los
 ingresos.
 Si solicito el aplazamiento de pago basándome en la condición (4), deberé utilizar la cantidad correspondiente al tamaño de mi hogar y al estado donde resido, según indicada en
 el cuadro siguiente. Si actualmente no resido en Estados Unidos, utilizaré la cantidad correspondiente a los 48 estados contiguos y al Distrito de Columbia.
                                                                         Estas sumas mensuales representan el 150% del umbral de la pobreza.
                             Tamaño del hogar del prestatario
                             (Vea la definición en la Sección 5)      Los 48 estados contiguos y
                                                                                                          Alaska                   Hawái
                                                                        el Distrito de Columbia
                                              1                               $1,353.75               $1,691.25              $1,557.50
                                              2                                 1,821.25                2,276.25               2,095.00
                                              3                                 2,288.75                2,861.25               2,632.50
                                              4                                 2,756.25                3,446.25               3,170.00
                               Para cada otra persona, añada:                     467.50                  585.00                 537.50




                                                                               Página 3 de 4
SECCIÓN 7: DÓNDE ENVIAR EL FORMULARIO CON LOS DATOS COMPLETOS
Envíe el formulario con los datos completos, y cualquier otra documentación necesaria, a      Si necesita ayuda para llenar el formulario, llame al siguiente número:
la siguiente dirección:                                                                       (De no indicarse ningún número de teléfono, llame a su acreedor.)
(De no indicarse ninguna dirección, remita el formulario a su acreedor.)




SECCIÓN 8: AVISOS IMPORTANTES
Aviso sobre la Ley de Confidencialidad de Información
En virtud de la Ley de Confidencialidad de Información de 1974 (Sección 552a del Título 5 del Código de Estados Unidos), es obligatorio poner a disposición del solicitante el
siguiente aviso:
La autoridad para reunir la información solicitada por medio del presente formulario deriva de la Sección 421 y siguientes de la Ley de Educación Superior de 1965, según
enmendada (Sección 1071 y siguientes del Título 20 del Código de Estados Unidos). La autoridad para solicitar y utilizar el número de Seguro Social del solicitante deriva de la
Sección 484(a)(4) de la Ley de Educación Superior (Sección 1091[a][4] del Título 20 del Código de Estados Unidos) y de la Sección 7701(b) del Título 30 del Código de Estados
Unidos. Si bien tienen carácter voluntario tanto la participación en el Federal Family Education Loan Program (Programa FFEL) como el proporcionar el número de Seguro Social, el
solicitante deberá facilitar la información solicitada, incluido el número de Seguro Social, para poder participar en el Programa.
La reunión de la información solicitada en el presente formulario (incluido el número de Seguro Social) se realiza con los siguientes fines principales: verificar la identidad del
solicitante; determinar el otorgamiento, al amparo del Programa FFEL, de préstamos nuevos o de beneficios en materia del pago de préstamos existentes (como por ejemplo, el
aplazamiento de pago, la indulgencia de morosidad, y la anulación o condonación de deudas); administrar los préstamos del solicitante, y, en caso de mora o incumplimiento de
pago, localizarlo, exigirle el pago de la deuda e informar a las entidades competentes la condición de los préstamos. También hacemos uso del número de Seguro Social como
identificador de la cuenta de préstamos del solicitante y para permitir a éste acceder electrónicamente a los datos relativos a la misma.
Al amparo de una cláusula, debidamente publicada en el sistema de registro de datos correspondiente, relativa al uso normal de la información recogida, los datos que se encuentran
en el expediente del solicitante se pueden poner a disposición de terceras entidades, ya sea según las circunstancias particulares del caso o en cumplimiento de un programa de
cotejo electrónico de datos. Tratándose del presente formulario, el uso normal de esta información incluye, sin carácter limitativo, la cesión de los datos a ciertas partes, señaladas
abajo, a fin de hacer lo siguiente: verificar la identidad del solicitante; determinar el otorgamiento de préstamos nuevos o de beneficios en materia del pago de préstamos existentes;
permitir la administración o cobro de los préstamos; hacer cumplir los términos y condiciones de los préstamos; investigar la posible comisión de fraude y verificar el cumplimiento de
las normas que rigen los programas federales de ayuda económica para los estudios superiores o localizar al solicitante en caso de mora o incumplimiento de pago. Las siguientes
son las partes a las que podemos destinar la información reunida: organismos federales, estatales y locales; particulares que tienen alguna relación con el solicitante, tales como
familiares, empleadores actuales y pasados, socios comerciales y personales; agencias de informes crediticios; instituciones educativas y financieras, y garantes. Para informar
sobre los cálculos del índice de incumplimiento de pago, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos estatales. Para facilitar el
historial de ayuda económica del solicitante, podemos ceder los datos a instituciones educativas. Para ayudar a los administradores del programa a llevar un control sobre la
devolución de fondos de préstamo y la anulación de préstamos, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos federales o estatales.
Para establecer un método estandarizado según el cual instituciones educativas puedan informar de forma eficiente sobre la dedicación de estudio del solicitante, podemos ceder los
datos a garantes o a instituciones financieras y educativas. Para dar orientación al solicitante en materia del pago de préstamos, podemos ceder los datos a garantes, a instituciones
financieras y educativas, o a organismos federales, estatales o locales.
En caso de litigio, podemos enviar los datos del solicitante al Departamento de Justicia, o al tribunal, entidad jurídica, abogado, parte o testigo correspondientes, cuando dicha cesión
se considere procedente y necesaria para la solución del mismo. Si estos datos, ya sean por separado o en conjunto con otra información, indican una posible violación de la ley,
podemos enviarlos a las autoridades competentes, para que se tomen las medidas pertinentes. Podemos enviar la información a congresistas en caso que usted les pida ayuda con
algún problema relacionado con los programas federales de asistencia estudiantil. En caso de denuncias, quejas o medidas disciplinarias en materia de empleo, podemos ceder los
datos a las entidades competentes, a fin de facilitar la adjudicación o investigación de las mismas. Si así se dispone en una convención colectiva de trabajo, podemos ceder los
datos a los sindicatos debidamente reconocidos al amparo del Capítulo 71 del Título 5 del Código de Estados Unidos. Podemos poner los datos a disposición de nuestros
contratistas si los necesitan para realizar funciones relacionadas con los programas en referencia. Antes de hacerlo, requerimos que el contratista ponga en práctica las medidas de
protección necesarias para cumplir con la Ley de Confidencialidad de Información. Los datos también pueden cederse, de conformidad con las protecciones previstas en la Ley de
Confidencialidad de Información, a aquellos investigadores que reúnan los requisitos correspondientes.
Aviso sobre la Ley de Reducción de Trámites
Según lo dispuesto en la Ley de Reducción de Trámites de 1995, ninguna persona estará en la obligación de responder a un instrumento de recolección de datos que no exhiba un
número de control vigente emitido por la Oficina de Administración y Presupuesto (OMB, por sus siglas en inglés). Para efectos del presente formulario, dicho número es 1845-0005.
Se calcula que se necesitan, como promedio, 0.16 horas (10 minutos) por respuesta, incluido el tiempo para leer las instrucciones, buscar la información en los documentos
correspondientes, reunir los datos necesarios, consignarlos en el formulario y revisarlos. Si usted tiene algún comentario sobre la exactitud de estos cálculos, o alguna
sugerencia sobre cómo mejorar el presente formulario, escriba a la siguiente dirección:

U.S. Department of Education, Washington, DC 20202-4537
Si tiene preguntas sobre el estado de tramitación de su formulario, escriba a la dirección indicada en la Sección 7.




                                                                                   Página 4 de 4
                                                                                                                                                     Updated 1/23/09
                          Economic Hardship Deferment Request Information Sheet
Location on the form                      Content of HRD (current form)                        Update based on current regulatory guidance, 2009 poverty
  currently in use                   OMB No. 1845-0005; Exp. Date 01/31/2009                   guidelines (HHS), and minimum wage rate effective July 24, 2008.
Economic Hardship Deferment Request (HRD)
Section 2              (B) the Poverty Line income for a family of two for my state            (B) 150% of the poverty guideline applicable to my family size and
Item (4)               (regardless of my actual family size).                                  state.
first (B)

Section 2              (A) Federal Minimum Wage Rate (monthly amount, based on                 (A) Federal Minimum Wage Rate (monthly amount, based on $6.55
Item (4)               $5.85 an hour): $1,014.00                                               an hour): $1,135.33
second (A) and (B)
                       (B) Poverty Lines for a Family of Two (monthly amounts):                (B) Amount for 150% of the poverty guideline for my family size and
                       $1,140.83 (48 contiguous states and the District of Columbia)           state as listed in the poverty guideline chart.
                       $1,426.67 (Alaska) $1,312.50 (Hawaii)

Section 2              (B) two times the Poverty Line income for a family of two for my        (B) two times 150% of the poverty guideline applicable to my family
Item (5)               state (regardless of my actual family size), as listed above under      size and state, as listed in the poverty guideline chart.
first (B)              condition (4).

Section 2              (B) the Poverty Line income for a family of two for my state, as        (B) 150% of the poverty guideline applicable to my family size and
Item (5)               listed above under condition (4).                                       state, as listed in the poverty guideline chart.
second (B)

Section 2              (B) the Poverty Line income for a family of two for my state            (B) 150% of the poverty guideline applicable to my family size and
Item ( 6)              (regardless of my actual family size), as listed above under            state, as listed in the poverty guideline chart.
(B)                    condition (4).

Section 6                If my economic hardship deferment eligibility is based on               If my economic hardship deferment eligibility is based on
7th bullet               conditions (4), (5), or (6), as described in Section 2, and I am        conditions (4), (5), or (6), as described in Section 2, I must use the
                         not currently residing in the United States, I will use the Poverty     applicable amount, based on my family size and state, provided in
                         Line amounts for my last state of residence in the United States.       the poverty guideline chart. If I am not currently residing in the
                                                                                                 United States, I will use the poverty guideline amounts for the 48
                                                                                                 contiguous states and District of Columbia.

WORKSHEET A
STEP 2                 (1) Line 1. Enter the amount listed below for your state: $______       (1) Line 1. Enter the applicable amount from the poverty guideline
(1)                                                                                            chart:      $______
                                                                                               Multiply the amount in Line 1 by two (2):   $_______

STEP 2                 (2) Line 2.            $ 2,028.00                                       (2) Line 2.           $ 2,270.66
(2)

STEP 2                 Amounts for Line 1, above:                                              No longer applicable; ignore this information.
at the end after (5)   $2,281.66 (if you live in any of the 48 contiguous states or the
                       District of Columbia) $2,853.34 (if you live in Alaska) $2,625.00 (if
                       you live in Hawaii).

                       NOTE: If you are not currently living in the United States, use the
                       amount for your last state of residence in the United States.

STEP 6                 (4) Line 4. Enter the amount listed below for your state:               (4) Line 4. Enter the applicable amount from the poverty guideline
(4)                                $ ______                                                    chart:      $ ______

STEP 6                 (5) Line 5.            $ 1,014.00                                       (5) Line 5.           $ 1135.33
(5)

STEP 6                 Amounts for Line 4, above:                                              No longer applicable; ignore this information.
at the end after (8)   $1,140.83 (if you live in any of the 48 contiguous states or the
                       District of Columbia)
                       $1,426.67 (if you live in Alaska)
                       $1,312.50 (if you live in Hawaii)

                       NOTE: If you are not currently living in the United States, use the
                       amount for your last state of residence in the United States.
                                                                                                                                                  Updated 1/23/09
WORKSHEET B
STEP 6                 (4) Line 4. Enter the amount listed below for your state: $ ______    (4) Line 4. Enter the applicable amount from the poverty guideline
(4)                                                                                          chart:      $ ______
                                                                                             Multiply the amount in Line 4 by 2.2 (=220%):          $______

STEP 6                 (5) Line 5.           $2,230.80                                       (5) Line 5.           $ 2,497.73
(5)

STEP 6                 Amounts for Line 4, above:                                            No longer applicable; ignore this information.
at the end after (8)   $2,509.83 (if you live in any of the 48 contiguous states or the
                       District of Columbia)
                       $3,138.67 (if you live in Alaska)
                       $2,887.50 (if you live in Hawaii)

                       NOTE: If you are not currently living in the United States, use the
                       amount for your last state of residence in the United States.




                        Economic Hardship Deferment Request Poverty Guideline Chart
                   These monthly amounts represent 150% of the poverty guideline for the applicable family size.
                                                     (Based on 2009 poverty guidelines)


                                                            These monthly amounts represent 150% of the poverty guideline
                  Borrower’s Family Size                   48 Contiguous States and
                                                                                           Alaska              Hawaii
                                                              District of Columbia
                            1                                         $1,353.75        $1,691.25          $1,557.50
                            2                                         $1,821.25        $2,276.25          $2,095.00
                            3                                         $2,288.75        $2,861.25          $2,632.50
                            4                                         $2,756.25        $3,446.25          $3,170.00
            For each additional person, add:                            $467.50         $585.00            $537.50

Family size means the number that is determined by counting the borrower, the borrower’s spouse, and the borrower’s
children, including unborn children who will be born during the period covered by the deferment, if the children receive
more than half their support from the borrower. A borrower’s family size includes other individuals if, at the time the
borrower requests the economic hardship deferment, the other individuals—(A) live with the borrower; and (B) receive
more than half their support from the borrower and will continue to receive this support from the borrower for the year the
borrower certifies family size. Support includes money, gifts, loans, housing, food, clothes, car, medical and dental care,
and payment of college costs.
                               Economic Hardship Deferment (HRD)
   Questions and Answers Related to July 1, 2009 Changes in Eligibility Criteria
                                                April 27, 2009


Background: The Economic Hardship Deferment (HRD) remains a viable option for many FFEL
borrowers. However, two eligibility criteria for the deferment are being eliminated effective July 1, 2009.
Those criteria are what is commonly known as the “20/220” criterion and the criterion that allows a
borrower “working less than full time” but making less than an established threshold to receive the
deferment. (These are options #5 and #6 on the current HRD form.)
Per the October 23, 2008 Final Rule, the regulatory changes to the economic hardship deferment apply to
‘deferment requests received by the lender on or after July 1, 2009, for deferment periods that begin on or
after that date’. In the Preamble to that Final Rule (pg. 63235), the Department clarified that lenders are
permitted to grant an economic hardship deferment based on the 20/220 or working less than full-time
criteria for a borrower who requests the deferment after July 1, 2009, ONLY in those instances where the
deferment period begins prior to July 1, 2009, and the deferment period does not exceed 12 months
from the date on which the period began (the pre-July 1, 2009 date.)
However, no additional periods of economic hardship deferment may be granted based on the soon-to-be
eliminated criteria at the conclusion of that deferment period, or for any deferment request received by the
lender on or after July 1, 2009, if the deferment period begins on or after the July 1, 2009 date.
The questions and answers below are provided to assist schools and lenders in understanding and
implementing these changes to the economic hardship deferment regulations.




Q1. If a borrower applies for HRD after June 30, 2009, but indicates that the deferment is based on
either the 20/220 or working less than full-time criteria and the qualifying condition began prior to July 1,
2009, can the borrower still be granted the deferment?
A1. Yes. As noted above, a lender is permitted to grant economic hardship deferment based on the
20/220 or working less than full time criteria if a borrower applies after July 1, 2009, provided the borrower
is eligible for the deferment and the qualifying condition begins prior to July 1, 2009. However, in order to
qualify for deferment, a borrower’s loans must be in repayment. See question #2 below that addresses
borrowers who have loans that are in ‘grace’ or ‘post-enrollment deferment’ at the time of the HRD
request.


Q2. A borrower requests and is eligible for an economic hardship deferment based on the 20/220
criterion on loans that are already in repayment. The deferment period begins prior to July 1, 2009.
However, the borrower also has Stafford loans that are in grace. Can the economic hardship deferment
be applied to the loans that are in grace once the grace period expires, thereby allowing all of the
borrower’s loans to be deferred? The deferment for all loans would expire on the same date – 12 months
after the loans in repayment entered the deferment period.
For example, a borrower has both Grad PLUS and Stafford loans. He graduates on May 16, 2009 and
opts out of the post-enrollment deferment available for his Grad PLUS loans. Therefore, his Grad PLUS


Developed by the NCHELP Program Regulations Committee and Student Loan Servicing Alliance (SLSA)                1
loans automatically move from an in-school deferment to repayment status beginning on May 17, 2009.
However, his Stafford loans are eligible for grace through November 15, 2009. The borrower applies and
is eligible for an economic hardship deferment based on the 20/220 criteria beginning May 17, 2009. The
lender would grant the economic hardship deferment on the Grad PLUS loans from May 17, 2009 through
May 16, 2010. Can the lender then apply the deferment to the borrower’s Stafford loans from November
16, 2009 through May 16, 2010?
A2. No. This question was pursued with the Department, and it was confirmed that an economic
hardship deferment may not be granted to a borrower based on either the 20/220 or the working less than
full-time criteria on loans that have not entered repayment prior to July 1, 2009. One of the underlying
requirements for obtaining a deferment is that the loan must be in repayment status, which means any
applicable grace period must expire first. In this example, the Stafford loans do not enter repayment
(grace does not expire) until November 15, 2009, which is after the trigger date of ‘deferment requests
received by the lender on or after July 1, 2009 for deferment periods that begin on or after that date’ for
the new economic hardship criteria. Therefore, even though the borrower’s Grad PLUS loans could be
deferred based on an 20/220 criterion, the borrower may not be granted an economic hardship deferment
based on the 20/220 or working less than full-time criteria on his or her Stafford loans because any
deferment period granted on the Stafford loans cannot commence until after July 1, 2009.


Q3. Borrowers may no longer choose to enter repayment while still in school to consolidate loans early.
However, some senior medical students whose separation date is mid-May may be interested in
consolidating their more recent Stafford loans with Grad PLUS and/or existing Consolidation loans in
order to apply for the economic hardship deferment under the 20/220 criterion prior to July 1, 2009.
Assuming the borrowers’ Federal Consolidation Loan applications could be processed prior to July 1,
2009, and the borrowers have done their ‘due diligence’ to determine if consolidation really makes sense,
there appears to be nothing that says they cannot consolidate their loans as soon as they are out of
school. The borrowers could end up losing most of their grace periods, but might be willing to do so if they
would be eligible for an economic hardship deferment based on the 20/220 criterion prior to its elimination
on July 1, 2009. Is this allowed?
A3. It is true that borrowers may not ‘waive’ any portion of the ‘in-school’ period for the purpose of
consolidating. However, borrowers continue to have the option of consolidating eligible loans that may be
in grace, thereby forfeiting all or a portion of the grace period on those loans (refer to Item 20 on the
current Federal Consolidation Loan Application and Promissory Note). In this example, the borrowers
may consolidate the Stafford loans immediately following graduation. If the Consolidation loan is
disbursed prior to July 1, 2009, the borrowers can apply for economic hardship deferment on the
Consolidation loans based on the 20/220 criteria, provided the deferment condition also begins prior to
July 1, 2009.


Q4. A borrower is currently on an economic hardship deferment that is scheduled to end after July 1,
2009, based on the 20/220 criterion. Can that borrower re-apply before July 1, 2009, based on the same
20/220 criterion, thereby extending the amount of time he is in deferment? If the borrower is required to
re-apply post July 1, 2009, he may not qualify for an economic hardship deferment based on the new
criteria.
A4. Yes, the borrower can re-apply for the economic hardship deferment, provided the borrower
continues to qualify for the deferment and also requests that the existing economic hardship deferment
end early, ensuring that the newly-granted economic hardship deferment period begins prior to July 1,
2009.

Developed by the NCHELP Program Regulations Committee and Student Loan Servicing Alliance (SLSA)            2
Q5. If a borrower’s economic hardship deferment begins prior to July 1, 2009 (for example, January 1,
2009), what months count toward any future loan forgiveness period should the borrower later request
income-based repayment (IBR)? Does the borrower first have to be on an IBR plan in order for the
economic hardship deferment months to count toward the forgiveness period?
A5. Any months of economic hardship deferment that occur on or after July 1, 2009 count toward the 25
years of repayment for purposes of loan forgiveness should a borrower request and qualify for IBR on or
after July 1, 2009. It does not matter what type of repayment plan the borrower was on while receiving
the economic hardship deferment, provided the deferment months occur after July 1, 2009 and the
borrower later requests and qualifies for IBR.


Q6. Prior to July 1, 2009, if a borrower was living outside of the United States, the lender would use the
borrower’s last state of legal residence for the applicable poverty levels in determining eligibility for the
economic hardship deferment. If that last state of legal residence was Alaska or Hawaii, the poverty
levels applicable to these states would be used. Effective July 1, 2009, for borrowers not residing in a
State that is listed in the HHS poverty guidelines notice (District of Columbia, Alaska, Hawaii and the 48
Contiguous States are the only States listed in the HHS notice), the lender must use the poverty
guidelines applicable to the 48 contiguous States and D.C. Therefore, we believe that if a borrower who
does not reside in a State submits an economic hardship deferment request for a deferment period prior
to July 1, 2009, that is based on the 20/220 or working less than full-time criteria, the lender should follow
the “old” rule and base the poverty level on the last State of legal residence. However, if a borrower who
does not reside in a State that is listed in the HHS poverty guidelines notice submits an economic
hardship deferment based on the revised HRD criteria that are effective on or after July 1, 2009, the
poverty level should be based on the guidelines applicable to the 48 contiguous States and D.C.
Borrowers residing in the other States, such as Puerto Rico, U.S. Territories and Freely Associated
States, would also use the guidelines applicable to the 48 contiguous States and D.C. Is this correct?
A6. Yes. As stated above in the “Background,” on page 63235 of the preamble the Department clarified
that an economic hardship deferment requested on or after July 1, 2009, for a deferment period that
starts before that date could be granted to a borrower for up to a 12-month period based on the 20/220
criteria. Consistent with that interpretation of the regulatory effective date, the use of poverty guidelines
that existed prior to July 1, 2009 may be applied to any deferment granted with a start date prior to July 1,
2009. Therefore, for a borrower who does not reside in a State that is listed in the HHS poverty
guidelines, the poverty level applicable to the borrower’s last state of legal residence is used. If the
borrower’s last state of legal residence was Alaska or Hawaii, the poverty guideline applicable to these
states is used.




Developed by the NCHELP Program Regulations Committee and Student Loan Servicing Alliance (SLSA)             3
                    EDUCATION RELATED DEFERMENT REQUEST                                                                                                     OMB No. 1845-0005
                                                                                                                                                            Form Approved
                    Federal Family Education Loan Program                                                                                                   Exp. Date 05/31/2012

                    WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents is subject to
                    penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.
    EDU
SECTION 1: BORROWER IDENTIFICATION
                                                                                                 Please enter or correct the following information.
                                                                                                 SSN |__|__|__|-|__|__|-|__|__|__|__|
                                                                                                 Name
                                                                                                 Address
                                                                                                 City, State, Zip Code
                                                                                                 Telephone - Home (        )
                                                                                                 Telephone - Other (       )
                                                                                                 E-mail Address (Optional)

SECTION 2: DEFERMENT REQUEST
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 5, 6, and 7.
 I meet the qualifications stated in Section 7 for the deferment checked below and request that my loan holder defer repayment of my loan(s):
   For all FFEL Program borrowers:
       While I am engaged in a full-time course of study in a GRADUATE FELLOWSHIP program.
       While I am engaged in a full-time REHABILITATION TRAINING program.
   For borrowers with an outstanding balance on at least one FFEL Program loan that was made before July 1, 1993, or who had an outstanding balance on a loan made before
   July 1, 1993, when he or she obtained a loan on or after July 1, 1993:
       While I am engaged in an INTERNSHIP/RESIDENCY* program at an institution of higher education, hospital, or health care facility.
       While I am engaged in an INTERNSHIP/RESIDENCY* program at any other institution or organization. Name of Internship/Residency
       program:____________________________________
   * Federal PLUS Loans qualify for INTERNSHIP/RESIDENCY deferments only if they were made before August 15, 1983; Federal Consolidation Loans do not qualify for
   INTERNSHIP/RESIDENCY deferments.
   For Federal Stafford and SLS borrowers whose first loans were made on or after July 1, 1987, and before July 1, 1993, or who had an outstanding balance on a loan made
   before July 1, 1993, when he or she obtained a loan on or after July 1, 1993:
       While I am teaching in a designated TEACHER SHORTAGE AREA.
SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
 I understand that:
   (1) I am not required to make payments of loan principal during my deferment. Interest will not be charged on my subsidized loan(s) during my deferment. However, interest will
       be charged on my unsubsidized loan(s).
   (2) I have the option of paying the interest that accrues on my unsubsidized loan(s) during my deferment.
   (3) I may choose to make interest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period.
             I wish to make interest payments on my unsubsidized loan(s) during my deferment.
   (4) My deferment will begin on the date the condition that qualifies me for the deferment began, as certified by the authorized official who completes Section 4 of this form.
   (5) My deferment will end on the earlier of the date that I no longer meet the condition that qualifies me for the deferment or the ending date of that condition as certified by the
       authorized official.
   (6) If my deferment does not cover all my past due payments, my loan holder may grant me a forbearance for all payments due before the begin date of my deferment or—if the
       period for which I am eligible for a deferment has ended—a forbearance for all payments due at the time my deferment request is processed.
   (7) If I have used all 24 months allowed for an INTERNSHIP/RESIDENCY Deferment, I can apply for a forbearance for up to 12 months at a time for the remainder of my
       internship/residency program.
   (8) My loan holder may grant me a forbearance on my loans for up to 60 days, if necessary, for the collection and processing of documentation related to my deferment request.
       Interest that accrues during the forbearance will not be capitalized.
 I certify that: (1) The information I provided in Sections 1 and 2 above is true and correct. (2) I will provide additional documentation to my loan holder, as required, to support my
   deferment status. (3) I will notify my loan holder immediately when the condition(s) that qualified me for the deferment ends. (4) I have read, understand, and meet the eligibility
   criteria of the deferment for which I have applied, as explained in Section 7.
 I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to contact me regarding my loan(s), including repayment of my
   loan(s), at the current or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded
   voice or text messages.
Borrower’s Signature                                                                                                              Date

SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION
I certify, to the best of my knowledge and belief, that the borrower named above is/was engaged in the program/teaching service indicated in Section 2, and that the borrower and the
borrower’s program/teaching service meet all of the eligibility requirements specified in Section 7.
The borrower’s program/teaching service begins/began on |__|__|-|__|__|-|__|__|__|__| and is expected to end/ended on |__|__|-|__|__|-|__|__|__|__|.
Teacher Shortage Area Deferment Only
The borrower is/was teaching in (area/curriculum) ____________________________, which is a shortage area designated by the U.S. Secretary of Education for the state of ______
for the school year beginning on |__|__|-|__|__|-|__|__|__|__| and ending on |__|__|-|__|__|-|__|__|__|__|. The borrower is/was teaching grade level __________.
Name of Institution                                                                                            OPE-ID (if applicable)
Address                                                                                                        City, State, Zip Code
Name/Title of Authorized Official                                                                              Telephone (        )
Authorized Official’s Signature                                                                                Date
                                                                                        Page 1 of 3
SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Report dates as month-day-year (MM-DD-YYYY). For example, ‘January 31, 2009’ = ‘01-31-2009’. An authorized official must either complete Section 4
or attach the institution’s own certification listing the required information. If you need help completing this form, contact your loan holder.
Return the completed form and any required documentation to the address shown in Section 8.
SECTION 6: DEFINITIONS
 Authorized certifying officials:
  • Authorized Graduate Fellowship Program Official
  • Rehabilitation Training Program Official
  • Internship/Residency Program Official (for all internships and residencies)
  • State Licensing Official (for internships required to begin professional practice or service; certification by a state licensing official, if required, must be provided on a separate
     statement attached to this form.)
  • Chief School Administrator (for borrowers teaching in teacher shortage areas; additional certification may be required if the Chief State School Officer has not provided a list of
     approved shortage areas to school administrators)
 Capitalization is the addition of unpaid interest to the principal balance of my loan. The principal balance of a loan increases when payments are postponed during periods of
  deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more
  payments may be required. The chart below provides estimates, for a $15,000 unsubsidized loan balance at a 9% interest rate, of the monthly payments due following a 12-month
  deferment. It compares the effects of paying the interest as it accrues, capitalizing the interest at the end of the deferment, and capitalizing interest quarterly and at the end of the
  deferment. My actual loan interest cost will depend on my interest rate, length of the deferment, and frequency of capitalization. Paying interest during the period of deferment
  lowers the monthly payment by about $18 and saves about $772 over the lifetime of the loan, as depicted in the chart below.
              Treatment of Interest Accrued                  Loan        Capitalized Interest       Principal to     Monthly       Number of Total Amount               Total Interest
                     During Deferment                       Amount          for 12 Months            Be Repaid       Payment        Payments           Repaid                Paid
      Interest is paid                                     $15,000.00           $0.00               $15,000.00       $190.01           120          $24,151.64*            $9,151.64
      Interest is capitalized at the end of deferment      $15,000.00         $1,350.00             $16,350.00       $207.11           120           $24,853.79            $9,853.79
      Interest is capitalized quarterly during
                                                           $15,000.00         $1,396.25             $16,396.25       $207.70           120           $24,924.09            $9,924.09
      deferment and at the end of deferment
  *Total amount repaid includes $1,350 of interest paid during the 12-month period of deferment.
 A deferment is a period during which I am entitled to postpone repayment of the principal balance of my loan(s). The federal government pays the interest that accrues during an
  eligible deferment for all subsidized Federal Stafford Loans and for Federal Consolidation Loans for which the Consolidation Loan application was received by my loan holder (1)
  on or after January 1, 1993, but before August 10, 1993, (2) on or after August 10, 1993, if it includes only Federal Stafford Loans that were eligible for federal interest subsidy, or
  (3) on or after November 13, 1997, for that portion of the Consolidation Loan that paid a subsidized FFEL Program loan or a subsidized Federal Direct Loan. I am responsible for
  the interest that accrues during this period on all other FFEL Program loans.
 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal Supplemental Loans for Students (SLS),
  Federal PLUS Loans, and Federal Consolidation Loans.
 Forbearance means permitting the temporary cessation of payments, allowing an extension of time for making payments, or temporarily accepting smaller payments than
  previously scheduled. I am responsible for paying the interest that accrues on my loan(s) during a forbearance. If I do not pay the interest that accrues, the interest may be
  capitalized.
 The holder of my FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the U.S. Department of Education.
SECTION 7: ELIGIBILITY CRITERIA FOR EDUCATION RELATED DEFERMENT REQUEST
GRADUATE FELLOWSHIP and REHABILITATION TRAINING Deferments
I may defer repayment of my loan(s) while I am:
• Engaged in a full-time course of study in a GRADUATE FELLOWSHIP program. To qualify: (1) My graduate fellowship program must (a) provide sufficient financial support to
   allow for full-time study for a period of at least 6 months; (b) require, prior to the awarding of financial support, a written statement from each applicant which explains the
   applicant’s objectives; (c) require a graduate fellow to submit periodic reports, projects, or other evidence of the graduate fellow’s progress, and (d) in the case of a course of study
   at a foreign university, accept the course of study for completion of the fellowship program. (2) I must (a) hold at least a Bachelor’s Degree conferred by an institution of higher
   education, and (b) have been accepted or recommended by an institution of higher education for acceptance into the graduate fellowship program on a full-time basis. (3) If I am in
   a medical internship or residency program, I am not eligible for this deferment.
• Engaged in a full-time REHABILITATION TRAINING program. To qualify: (1) My training program must (a) be licensed, approved, certified or recognized as providing
   rehabilitation training to disabled individuals by the Department of Veterans Affairs or a state agency responsible for vocational rehabilitation, drug abuse treatment, mental health
   services, or alcohol abuse treatment programs; (b) provide services under a written individualized plan that specifies the date the services are expected to end; and (c) be
   structured in a way that requires a substantial commitment by me to my rehabilitation. (“Substantial commitment” means a commitment of time and effort that would normally
   prevent a person from being employed 30 or more hours per week in a position expected to last at least three months.) (2) I must be either receiving, or scheduled to receive,
   these rehabilitation services.
INTERNSHIP/RESIDENCY Deferments
To qualify:
• I must have an outstanding balance on a FFEL Program loan, which was made before July 1, 1993, or I must have had an outstanding balance on a FFEL Program loan made
   before July 1, 1993, when I obtained a loan on or after July 1, 1993. If I am a Federal PLUS Loan borrower, I am eligible for the INTERNSHIP/RESIDENCY Deferment only on
   PLUS loans made before August 15, 1983.
I may defer repayment of my loan(s) while I am:
• Engaged in an INTERNSHIP/RESIDENCY program. (Maximum eligibility is 2 years; borrowers may request forbearance for the remainder of a medical or dental
   internship/residency program. Dental Interns/Residents are encouraged to apply for an In-School Deferment.) To qualify: (1) I must have been accepted into an
   internship/residency program which must (a) be a supervised training program, and (b) require that I hold at least a Bachelor’s Degree before acceptance into the program. (2) In
   addition, my program must either (a) lead to a degree or certificate from an institution of higher education, a hospital, or a health care facility that offers postgraduate training, or (b)
   be required before I may be certified for professional practice or service. (3) If my program does not lead to a degree or certificate, but is required before I may be certified
   for professional practice or service, I must also provide (attached to this form) a separate statement from the appropriate state licensing agency certifying this
   requirement, in addition to the Authorized Official’s Certification in Section 4.
                                                                                                                                                        SECTION 7 CONTINUES ON PAGE 3




                                                                                        Page 2 of 3
SECTION 7: ELIGIBILITY CRITERIA FOR EDUCATION RELATED DEFERMENT REQUEST (CONTINUED)

TEACHER SHORTAGE AREA Deferments
To qualify :
• I am eligible for the TEACHER SHORTAGE AREA deferment only if I am a Federal Stafford or SLS loan borrower whose first FFEL Program loan was made on or after July 1,
   1987, and before July 1, 1993, or I had an outstanding balance on a loan obtained on or after July 1, 1987, and before July 1, 1993, when I obtained a loan on or after July 1,
   1993. If I am a Federal PLUS Loan borrower, I am not eligible for the Teacher Shortage Area deferment.
I may defer repayment of my loan(s) while I am:
• Teaching in a designated TEACHER SHORTAGE AREA. (Maximum eligibility is 3 years; borrowers must reapply each school year.) To qualify, I must teach full time in a public or
   non-profit private elementary or secondary school in a geographic region or specific grade level, academic, instructional, subject matter or discipline classification that has been
   designated as a shortage area by the U.S. Department of Education. (I may contact my Chief School Administrator or Chief State School Officer for a list of my state’s shortage
   areas.) I may reapply for a continuation of this deferment even if my teaching area is no longer classified as a shortage area.

SECTION 8: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST
Return the completed deferment request and any required documentation to:                         If you need help completing this form, call:
(If no address is shown, return to your loan holder.)                                             (If no telephone number is shown, call your loan holder.)




SECTION 9: IMPORTANT NOTICES
Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §421 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and the
authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family
Education Loan Program (FFELP) and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
(such as a deferment, forbearance, discharge, or forgiveness) under the FFELP, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and
report on your loan(s) if your loan(s) becomes delinquent or in default. We also use your SSN as an account identifier and to permit you to access your account information
electronically.
The information in your file may be disclosed, on a case-by-case basis or under a computer matching program, to third parties as authorized under routine uses in the appropriate
systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local agencies, to private parties such as relatives,
present and former employers, business and personal associates, to consumer reporting agencies, to financial and educational institutions, and to guaranty agencies in order to verify
your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s), to investigate
possible fraud and to verify compliance with federal student financial aid program regulations, or to locate you if you become delinquent in your loan payments or if you default. To
provide default rate calculations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history
information, disclosures may be made to educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal or state agencies. To provide a standardized method for educational institutions to efficiently submit student enrollment
status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in repayment efforts, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to the
litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate authority for action. We may send
information to members of Congress if you ask them to help you with federal student aid questions. In circumstances involving employment complaints, grievances, or disciplinary
actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective bargaining agreement, we may disclose records to a labor organization
recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for the purpose of performing any programmatic function that requires disclosure of records.
Before making any such disclosure, we will require the contractor to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act
safeguards.
Paperwork Reduction Notice
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The
valid OMB control number for this information collection is 1845-0005. The time required to complete this information collection is estimated to average 0.16 hours (10 minutes) per
response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and complete and review the information collection. If you
have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, DC 20202-4537
If you have questions regarding the status of your individual submission of this form, write directly to the address shown in Section 8.




                                                                                         Page 3 of 3
                   SOLICITUD DE APLAZAMIENTO DE PAGO:                                                                                                                  N.o de OMB: 1845-0005
                                                                                                                                                                       Formulario aprobado

                   ESTUDIOS O DOCENCIA
                                                                                                                                                                       Caduca: 31 mayo 2012


                   Federal Family Education Loan ProgramSM
   EDU             AVISO: El que a sabiendas haga declaraciones falsas o engañosas en el presente formulario, o en cualquier documento adjunto al mismo, quedará
                   sujeto a sanciones, las cuales pueden incluir las multas, el encarcelamiento o ambas penas, de conformidad con el Código Penal de EE.UU. y con la
                   Sección 1097 del Título 20 del Código de Estados Unidos.

SECCIÓN 1: DATOS PERSONALES DEL PRESTATARIO
                                                                                                   Favor de introducir o corregir la siguiente información:
                                                                                                   N.o de Seguro Social
                                                                                                   Nombre y apellido
                                                                                                   Dirección
                                                                                                   Ciudad, estado, código postal
                                                                                                   Teléfono (domicilio) (     )
                                                                                                   Teléfono (alternativo) (      )
                                                                                                   Correo electrónico (opcional)
SECCIÓN 2: SOLICITUD DE APLAZAMIENTO DE PAGO
Antes de responder a las preguntas, lea todo el formulario detenidamente, incluyendo las indicaciones y otra información que se hallan en las Secciones 5, 6 y 7.
   Cumplo con los requisitos, estipulados en la Sección 7, para acogerme al aplazamiento de pago por el motivo indicado abajo, y solicito que mi acreedor aplace el pago de mis
   préstamos mientras:
  Para todo prestatario del programa de préstamos educativos Federal Family Education Loan Program (FFELSM):
       Participo a tiempo completo en un programa de BECAS DE INVESTIGACIÓN DE POSGRADO.
       Participo a tiempo completo en un programa de REHABILITACIÓN Y CAPACITACIÓN.
   Para los prestatarios con algún saldo pendiente en por lo menos un préstamo del Programa FFEL hecho antes del 1 de julio de 1993, o que tenían un saldo en algún préstamo
   hecho antes del 1 de julio de 1993 cuando se obtuvo otro préstamo el 1 de julio de 1993 o posterior:
       Participo en un programa de PRÁCTICAS O RESIDENCIAS* en una institución de educación superior, hospital o centro de atención médica.
       Participo en un programa de PRÁCTICAS O RESIDENCIAS* en cualquier otra institución o entidad. Especifique el nombre del programa de prácticas o
        residencias:____________________________________
   * Los que hayan obtenido Préstamos Federales PLUS pueden acogerse al aplazamiento de pago por participación en un programa de PRÁCTICAS O RESIDENCIAS, siempre
   que los préstamos se hayan hecho antes del 15 de agosto de 1983; los que hayan obtenido Préstamos Federales de Consolidación no pueden acogerse al aplazamiento de
   pago por dicha participación.
   Para los prestatarios de Préstamos Stafford o Préstamos Federales Suplementarios para Estudiantes (SLS) que obtuvieron sus primeros préstamos el 1 de julio de 1987 o
   posterior pero antes del 1 de julio de 1993, o que tenían un saldo en algún préstamo hecho antes del 1 de julio de 1993 cuando se obtuvo otro préstamo el 1 de julio de 1993
   o posterior:
       Presto servicios de docencia en una CATEGORÍA DE ESCASEZ DE PERSONAL DOCENTE.
SECCIÓN 3: ACEPTACIÓN, CERTIFICACIÓN Y AUTORIZACIÓN DEL PRESTATARIO
   Entiendo y acepto lo siguiente:
  (1) No tengo obligación de efectuar pagos al capital del préstamo durante la vigencia del aplazamiento de pago. Durante este período, no se me cobrarán los intereses
      producidos por mis préstamos que tengan subsidio del interés. Sin embargo, se me cobrarán los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (2) Tengo la opción de pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (3) Puedo optar por pagar el interés, marcando la casilla de abajo. Mi acreedor podrá capitalizar los intereses que no se paguen durante el período de aplazamiento.
           Deseo pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (4) El aplazamiento de pago entrará en vigor en la fecha de inicio de la condición que justificó el otorgamiento de tal beneficio, según certifique esta fecha el funcionario o
      empleado autorizado que llene la Sección 4 del presente formulario.
  (5) El aplazamiento de pago vencerá en la primera de las dos fechas siguientes: la fecha en que ya no cumpla con la condición que justificó el otorgamiento de tal beneficio o la
      fecha de terminación de dicha condición, según certifique la fecha el funcionario o empleado autorizado.
  (6) Si el aplazamiento de pago no abarca todas las cuotas atrasadas, mi acreedor puede concederme un período de indulgencia de morosidad que abarque las que hayan
      vencido antes de la fecha de entrada en vigor del aplazamiento. En caso de que haya terminado el período de vigencia del aplazamiento, mi acreedor puede otorgarme un
      período de indulgencia que abarque toda cuota que haya vencido hasta la fecha de tramitación de la presente solicitud.
  (7) Si se agotan los 24 meses permitidos para gozar del aplazamiento por motivo de mi participación en un programa de PRÁCTICAS O RESIDENCIAS, puedo solicitar períodos
      de indulgencia de morosidad, de una duración máxima de 12 meses cada uno, a fin de abarcar el resto de mi participación en el programa.
  (8) Mi acreedor puede concederme, según sea necesario, un período de indulgencia de morosidad por una duración máxima de 60 días, por motivo de la recopilación y
      tramitación de los documentos relativos a mi solicitud de aplazamiento de pago. No se capitalizarán los intereses producidos durante el plazo de vigencia de este tipo de
      indulgencia.
   Certifico lo siguiente: (1) que la información que proporcioné en las Secciones 1 y 2, arriba, es correcta y verídica; (2) que aportaré documentación complementaria a mi
   acreedor, según sea necesario, que acredite las circunstancias en cuya virtud me acojo al aplazamiento de pago; (3) que avisaré a mi acreedor, de forma inmediata, una vez
   que hayan terminado las condiciones que justificaron el aplazamiento de pago, y (4) que he leído, entendido y cumplido los requisitos y condiciones cuya satisfacción es
   necesaria para la concesión del aplazamiento de pago por los motivos señalados en el presente formulario de solicitud, según lo expuesto en la Sección 7.
   Autorizo a la institución educativa, al acreedor, al garante, al Departamento y a sus respectivos agentes y contratistas a comunicarse conmigo respecto a mis préstamos,
   incluido el pago de los mismos, al número actual o futuro (si lo proporciono) de mi teléfono móvil u otro dispositivo inalámbrico, por medio de sistemas de marcado automático,
   mensajes de texto o mensajes de voz artificial o grabados.
Firma del prestatario                                                                                                                       Fecha




                                                                                        Página 1 de 4
SECCIÓN 4: CERTIFICACIÓN DEL FUNCIONARIO O EMPLEADO AUTORIZADO
Certifico que, según mi leal saber y entender, el prestatario arriba indicado participa o participó en el programa, o presta o prestó el servicio docente, indicados en la Sección 2 del
presente formulario, y que el prestatario y el programa educativo, o el servicio docente, cumplen todos los requisitos estipulados en la Sección 7.
El programa o servicio docente del prestatario empezó o empezará el                                          y terminó o está previsto terminar el                                         .
Sólo para efectos del aplazamiento de pago por servicio en una categoría de escasez de personal docente
El prestatario presta o prestó servicio docente en (región o materia) ____________________________, que constituye, según el secretario de Educación de EE.UU., una categoría
en la que existe una escasez de personal docente correspondiente al Estado de ______, durante el año escolar que empezó o empezará
el                                         y que terminó o terminará el                                 . El prestatario presta o prestó el servicio docente en el _______ grado.

Nombre de la institución                                                                                          OPE-ID (si corresponde)

Dirección                                                                                                         Ciudad, estado, código postal
Nombre, apellido y
puesto del funcionario o
empleado autorizado                                                                                               Teléfono (          )
Firma del funcionario
o empleado autorizado                                                                                             Fecha

SECCIÓN 5: INSTRUCCIONES PARA LLENAR EL FORMULARIO
Escriba sus respuestas a máquina o con letra de molde y tinta oscura. Escriba las fechas en el formato mes-día-año (MM-DD-AAAA). Por ejemplo, «31 de enero de 2009» equivale a
«01-31-2009». El funcionario o empleado autorizado deberá rellenar la Sección 4 o adjuntar la certificación, facilitada por la institución, en la que figure la información necesaria. Si
usted necesita ayuda para llenar el presente formulario, comuníquese con su acreedor.
Remita el formulario con los datos completos, y cualquier documentación solicitada, a la dirección indicada en la Sección 8.
SECCIÓN 6: DEFINICIONES
   El acreedor de mis préstamos del Programa FFEL puede ser una entidad prestamista, garante o financiera (del mercado secundario), o el Departamento de Educación de EE.UU.
   El aplazamiento de pago consiste en un período durante el cual tengo derecho a posponer el pago del capital de mis préstamos. El Departamento de Educación de EE.UU.
   sufraga los intereses producidos durante el aplazamiento de pago debidamente tramitado, todo Préstamo Federal Stafford con subsidio del interés y todo Préstamo Federal de
   Consolidación cuya solicitud llegó a mi acreedor (1) el 1 de enero de 1993 o posterior pero antes del 10 de agosto de 1993, (2) el 10 de agosto de 1993 o posterior, siempre que la
   solicitud incluyera sólo los Préstamos Federales Stafford que gozaban del subsidio federal del interés, o (3) el 13 de noviembre de 1997 o posterior, cuando se trate de la porción
   del préstamo de consolidación con la que se liquidó un préstamo educativo con subsidio del interés obtenido del Programa FFEL o del Direct Loan ProgramSM. Tengo la
   responsabilidad de pagar los intereses producidos durante este período por cualquier otro préstamo hecho al amparo del Programa FFEL.
   La capitalización consiste en añadir los intereses pendientes de pago al saldo de capital del préstamo. El saldo de capital del préstamo aumenta cuando se postergan los pagos,
   durante los períodos de aplazamiento de pago o de indulgencia de morosidad, y se capitalizan los intereses. Como resultado de esto, puede que se produzcan más intereses
   durante la vigencia del préstamo, que se aumente la cantidad de la cuota mensual o que se incremente el número de los pagos. En el cuadro siguiente, se presentan cálculos
   aproximados de las cuotas mensuales de un préstamo sin subsidio del interés, hecho por un monto de $15,000 y con una tasa de 9 por ciento, después de un período de aplaza-
   miento de pago de 12 meses de duración. Se comparan los efectos de las diferentes maneras de tratar los intereses del préstamo: pagarlos a medida que se van produciendo,
   capitalizarlos al final del período de aplazamiento de pago y capitalizarlos trimestralmente y al final del período de aplazamiento de pago. El costo efectivo de los intereses de mi
   préstamo dependerá de la tasa de interés, de la duración del aplazamiento de pago y de la frecuencia de capitalización de los intereses. Como se puede apreciar en el cuadro, si
   los intereses se van pagando durante el período del aplazamiento de pago, la cuota mensual se rebaja en unos $18 y se ahorran casi $772 durante la vigencia del préstamo.
        Tratamiento de los intereses producidos         Cantidad del         Intereses capitalizados       Capital a        Cuota          Número                        Total pagado
                                                                                                                                                       Total pagado
              durante el aplazamiento de pago            préstamo                  (12 meses)               pagar          mensual        de cuotas                      en intereses
       Pagar los intereses durante
                                                          $15,000.00                  $0.00               $15,000.00        $190.01         120         $24,151.64*        $9,151.64
       el aplazamiento de pago
       Capitalizar los intereses al final
                                                          $15,000.00                $1,350.00             $16,350.00        $207.11         120         $24,853.79         $9,853.79
       del aplazamiento de pago
       Capitalizar los intereses cada
        trimestre durante el aplazamiento                 $15,000.00                $1,396.25             $16,396.25        $207.70         120         $24,924.09         $9,924.09
       de pago y al final del mismo
   * El total pagado incluye los $1,350 de intereses pagados durante los 12 meses del aplazamiento de pago.
   El Federal Family Education Loan Program (Programa FFEL) incluye los Préstamos Federales Stafford (con y sin subsidio del interés), los Préstamos Federales
   Suplementarios para Estudiantes (SLS), los Préstamos Federales PLUS y los Préstamos Federales de Consolidación.
   Funcionarios y empleados autorizados para certificar los datos consignados:
   • Funcionario o empleado autorizado de un programa de becas de investigación de posgrado
   • Funcionario o empleado de un programa de rehabilitación y capacitación
   • Funcionario o empleado de un programa de prácticas o residencias (para efectos de toda plaza de prácticas o de residencia)
   • Funcionario de un organismo del estado que expide licencias de ejercicio profesional (para efectos de prácticas cuyo cumplimiento es necesario para iniciar el ejercicio de
       alguna profesión o la prestación de algún servicio); debe aportarse, en una declaración adjunta al presente formulario, la certificación por parte de algún funcionario del
       organismo estatal que otorga licencias de ejercicio profesional.
   • Administrador principal de una escuela (para efectos de la prestación de servicio docente en una categoría en la que existe una escasez de personal docente; puede ser
       necesaria la certificación por otra entidad si el encargado principal de escuelas en el estado correspondiente no ha facilitado a los administradores escolares una lista de las
       categorías que están aprobadas al efecto)
   Indulgencia de morosidad se refiere a la suspensión temporal de las cuotas del préstamo, a la prolongación del plazo de vencimiento de las cuotas o a la reducción temporal de
   la cantidad programada de las cuotas. Tengo la responsabilidad de pagar los intereses producidos por mis préstamos durante el período de indulgencia de morosidad. Si no
   pago los intereses, éstos pueden capitalizarse.




                                                                                    Página 2 de 4
SECCIÓN 7: REQUISITOS PARA ACOGERSE AL APLAZAMIENTO DE PAGO POR ESTUDIOS O DOCENCIA
Aplazamiento de pago por participación en programas de BECAS DE INVESTIGACIÓN DE POSGRADO o de REHABILITACIÓN Y CAPACITACIÓN
Puedo acogerme al aplazamiento del pago de mis préstamos mientras:
• Participo a tiempo completo en un programa de BECAS DE INVESTIGACIÓN DE POSGRADO. Para poder acogerme al aplazamiento de pago por este motivo, debe cumplirse
  lo siguiente: (1) El programa de becas de investigación de posgrado en que participo debe (a) proveer los medios económicos que sean suficientes para la realización de los
  estudios a tiempo completo, durante un plazo mínimo de seis meses; (b) pedir a cada solicitante, previo al otorgamiento de ayuda económica, una declaración por escrito en la
  que éste exponga sus objetivos; (c) pedir que el becario de investigación entregue, con cierta frecuencia, informes, proyectos u otras pruebas de su progreso, y (d) tratándose de
  estudios cursados en universidades extranjeras, convalidar los estudios para efectos del cumplimiento del programa de becas de investigación. (2) Debo (a) tener, como mínimo,
  algún título universitario de cuatro años (bachelor’s degree) otorgado por una institución de educación superior, y (b) haber sido admitido por una institución de educación superior
  (o haber recibido su recomendación para tal efecto) al programa de becas de investigación de posgrado, para realizar estudios a tiempo completo. (3) Si participo en un programa
  de prácticas o residencias médicas, no puedo acogerme al aplazamiento de pago por los motivos expuestos en el presente apartado.
• Participo a tiempo completo en un programa de REHABILITACIÓN Y CAPACITACIÓN. Para poder acogerme al aplazamiento de pago por este motivo, debe cumplirse lo
  siguiente: (1) El programa en referencia debe: (a) contar con la pertinente licencia, autorización, certificación o reconocimiento —expedidos por el Departamento de Asuntos de
  Veteranos o por el organismo del estado correspondiente que se encarga de los programas de rehabilitación profesional, de tratamiento de drogadictos, de salud mental o de
  tratamiento de alcohólicos— que sea necesario para la prestación de servicios de rehabilitación y capacitación a personas con discapacidad; (b) prestar servicios conforme a un
  plan, en forma escrita, elaborado según las necesidades del cliente y en el que se especifique la fecha prevista de terminación de los servicios, y (c) ser organizado de manera
  que suponga un compromiso importante por mi parte con mi propia rehabilitación. («Compromiso importante» significa un compromiso de tiempo y esfuerzo que, en
  circunstancias normales, impediría a una persona trabajar 30 horas semanales o más en un puesto con una duración mínima prevista de tres meses.) (2) La prestación de los
  servicios de rehabilitación debe estar en marcha o programada para ponerse en marcha.

Aplazamiento de pago por PRÁCTICAS O RESIDENCIAS
Para poder acogerme al aplazamiento de pago por este motivo, debe cumplirse lo siguiente:
• Debo tener un saldo pendiente de pago en algún préstamo hecho mediante el Programa FFEL antes del 1 de julio de 1993, o debía tener, en el momento de obtener otro
  préstamo el 1 de julio de 1993 o posterior, un saldo pendiente en algún Préstamo FFEL hecho antes del 1 de julio de 1993.En caso de haber obtenido un Préstamo Federal
  PLUS, puedo acogerme, por mi participación en un programa de PRÁCTICAS O RESIDENCIAS, al aplazamiento del pago solamente de los Préstamos PLUS hechos antes del
  15 de agosto de 1983.
Puedo acogerme al aplazamiento del pago de mis préstamos mientras:
• Participo en un programa de PRÁCTICAS O RESIDENCIAS. (La duración máxima del aplazamiento de pago es de dos años. En caso de que dure más de dos años el programa
  de prácticas o residencias médicas u odontológicas, el prestatario puede solicitar un período de indulgencia de morosidad que abarque el resto del programa. A los estudiantes
  de odontología que tengan plaza de prácticas o de residencia se recomienda que utilicen el formulario «Solicitud por aplazamiento de pago por estudios».) Para poder acogerme
  al aplazamiento de pago por este motivo, debe cumplirse lo siguiente: (1) Debo haber sido admitido a un programa de prácticas o de residencias que (a) sea supervisado y (b)
  tenga como requisito de participación el tener, como mínimo, algún título universitario de cuatro años (bachelor’s degree) obtenido previo a la admisión al programa. (2) También,
  mi participación en el programa debe (a) conducir a la obtención de un título o certificado en una institución de educación superior, hospital o centro de atención médica en el que
  se ofrecen estudios de posgrado o (b) constituir un requisito que debo cumplir antes de que se me certifique para el ejercicio profesional o la prestación de algún servicio. (3) Si
  mi participación en el programa no conduce a ningún título o certificado, pero sí es necesaria para que yo pueda recibir la certificación para ejercer mi profesión o
  prestar algún servicio, deberé también aportar (adjunta al presente formulario) una declaración emitida por el organismo del estado correspondiente que tenga
  competencia en materia de licencias de ejercicio profesional, y también la certificación del funcionario o empleado autorizado, la que se encuentra en la Sección 4.

Aplazamiento de pago por SERVICIO EN CATEGORÍAS DE ESCASEZ DE PERSONAL DOCENTE
Para poder acogerme al aplazamiento de pago por este motivo, debe cumplirse lo siguiente:
• Debo haber obtenido Préstamos Federales Stafford o Préstamos SLS y haber obtenido el primero de sus préstamos del Programa FFEL el 1 de julio de 1987 o posterior pero
  antes del 1 de julio de 1993, o debía haber tenido, en el momento de obtener otro préstamo el 1 de julio de 1993 o posterior, un saldo pendiente de pago en algún préstamo
  obtenido el 1 de julio de 1987 o posterior pero antes del 1 de julio de 1993. En caso de haber obtenido un Préstamo Federal PLUS, no puedo acogerme al aplazamiento de
  pago por servicio en categorías de escasez de personal docente.
Puedo acogerme al aplazamiento del pago de mis préstamos mientras:
• Presto servicios de docencia en una CATEGORÍA DE ESCASEZ DE PERSONAL DOCENTE. (La duración máxima del aplazamiento de pago es de tres años. Para seguir
   acogido al aplazamiento, hay que realizar los pertinentes trámites de solicitud cada año escolar.) Para acogerme al aplazamiento de pago por este motivo, debo ser docente con
   dedicación exclusiva en una escuela de enseñanza primaria o secundaria (ya sea pública o privada) sin fines de lucro, en una categoría —ya sea una región geográfica, grado
   escolar, materia, disciplina u otra categoría académica o pedagógica— en la que existe, según el Departamento de Educación de EE.UU., una escasez de personal docente.
   (Puede comunicarme con el administrador principal de mi escuela o con el encargado principal de escuelas en mi estado, a fin de conseguir la lista de las categorías que
   corresponden al estado donde presto servicio docente.) Tengo el derecho a solicitar la continuación del aplazamiento de pago, aunque la categoría en la que presto servicios de
   docencia pierda su clasificación a los efectos de la escasez de personal docente.




                                                                                  Página 3 de 4
SECCIÓN 8: DÓNDE ENVIAR EL FORMULARIO CON LOS DATOS COMPLETOS
Envíe el formulario con los datos completos, y cualquier otra documentación necesaria, a      Si necesita ayuda para llenar el formulario, llame al siguiente número:
la siguiente dirección:                                                                       (De no indicarse ningún número de teléfono, llame a su acreedor.)
(De no indicarse ninguna dirección, remita el formulario a su acreedor.)




SECCIÓN 9: AVISOS IMPORTANTES
Aviso sobre la Ley de Confidencialidad de Información
En virtud de la Ley de Confidencialidad de Información de 1974 (Sección 552a del Título 5 del Código de Estados Unidos), es obligatorio poner a disposición del solicitante el
siguiente aviso:
La autoridad para reunir la información solicitada por medio del presente formulario deriva de la Sección 421 y siguientes de la Ley de Educación Superior de 1965, según
enmendada (Sección 1071 y siguientes del Título 20 del Código de Estados Unidos). La autoridad para solicitar y utilizar el número de Seguro Social del solicitante deriva de la
Sección 484(a)(4) de la Ley de Educación Superior (Sección 1091[a][4] del Título 20 del Código de Estados Unidos) y de la Sección 7701(b) del Título 30 del Código de Estados
Unidos. Si bien tienen carácter voluntario tanto la participación en el Federal Family Education Loan Program (Programa FFEL) como el proporcionar el número de Seguro Social, el
solicitante deberá facilitar la información solicitada, incluido el número de Seguro Social, para poder participar en el Programa.
La reunión de la información solicitada en el presente formulario (incluido el número de Seguro Social) se realiza con los siguientes fines principales: verificar la identidad del
solicitante; determinar el otorgamiento, al amparo del Programa FFEL, de préstamos nuevos o de beneficios en materia del pago de préstamos existentes (como por ejemplo, el
aplazamiento de pago, la indulgencia de morosidad, y la anulación o condonación de deudas); administrar los préstamos del solicitante, y, en caso de mora o incumplimiento de
pago, localizarlo, exigirle el pago de la deuda e informar a las entidades competentes la condición de los préstamos. También hacemos uso del número de Seguro Social como
identificador de la cuenta de préstamos del solicitante y para permitir a éste acceder electrónicamente a los datos relativos a la misma.
Al amparo de una cláusula, debidamente publicada en el sistema de registro de datos correspondiente, relativa al uso normal de la información recogida, los datos que se encuentran
en el expediente del solicitante se pueden poner a disposición de terceras entidades, ya sea según las circunstancias particulares del caso o en cumplimiento de un programa de
cotejo electrónico de datos. Tratándose del presente formulario, el uso normal de esta información incluye, sin carácter limitativo, la cesión de los datos a ciertas partes, señaladas
abajo, a fin de hacer lo siguiente: verificar la identidad del solicitante; determinar el otorgamiento de préstamos nuevos o de beneficios en materia del pago de préstamos existentes;
permitir la administración o cobro de los préstamos; hacer cumplir los términos y condiciones de los préstamos; investigar la posible comisión de fraude y verificar el cumplimiento de
las normas que rigen los programas federales de ayuda económica para los estudios superiores o localizar al solicitante en caso de mora o incumplimiento de pago. Las siguientes
son las partes a las que podemos destinar la información reunida: organismos federales, estatales y locales; particulares que tienen alguna relación con el solicitante, tales como
familiares, empleadores actuales y pasados, socios comerciales y personales; agencias de informes crediticios; instituciones educativas y financieras, y garantes. Para informar
sobre los cálculos del índice de incumplimiento de pago, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos estatales. Para facilitar el
historial de ayuda económica del solicitante, podemos ceder los datos a instituciones educativas. Para ayudar a los administradores del programa a llevar un control sobre la
devolución de fondos de préstamo y la anulación de préstamos, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos federales o estatales.
Para establecer un método estandarizado según el cual instituciones educativas puedan informar de forma eficiente sobre la dedicación de estudio del solicitante, podemos ceder los
datos a garantes o a instituciones financieras y educativas. Para dar orientación al solicitante en materia del pago de préstamos, podemos ceder los datos a garantes, a instituciones
financieras y educativas, o a organismos federales, estatales o locales.
En caso de litigio, podemos enviar los datos del solicitante al Departamento de Justicia, o al tribunal, entidad jurídica, abogado, parte o testigo correspondientes, cuando dicha cesión
se considere procedente y necesaria para la solución del mismo. Si estos datos, ya sean por separado o en conjunto con otra información, indican una posible violación de la ley,
podemos enviarlos a las autoridades competentes, para que se tomen las medidas pertinentes. Podemos enviar la información a congresistas en caso que usted les pida ayuda con
algún problema relacionado con los programas federales de asistencia estudiantil. En caso de denuncias, quejas o medidas disciplinarias en materia de empleo, podemos ceder los
datos a las entidades competentes, a fin de facilitar la adjudicación o investigación de las mismas. Si así se dispone en una convención colectiva de trabajo, podemos ceder los
datos a los sindicatos debidamente reconocidos al amparo del Capítulo 71 del Título 5 del Código de Estados Unidos. Podemos poner los datos a disposición de nuestros
contratistas si los necesitan para realizar funciones relacionadas con los programas en referencia. Antes de hacerlo, requerimos que el contratista ponga en práctica las medidas de
protección necesarias para cumplir con la Ley de Confidencialidad de Información. Los datos también pueden cederse, de conformidad con las protecciones previstas en la Ley de
Confidencialidad de Información, a aquellos investigadores que reúnan los requisitos correspondientes.
Aviso sobre la Ley de Reducción de Trámites
Según lo dispuesto en la Ley de Reducción de Trámites de 1995, ninguna persona estará en la obligación de responder a un instrumento de recolección de datos que no exhiba un
número de control vigente emitido por la Oficina de Administración y Presupuesto (OMB, por sus siglas en inglés). Para efectos del presente formulario, dicho número es 1845-0005.
Se calcula que se necesitan, como promedio, 0.16 horas (10 minutos) por respuesta, incluido el tiempo para leer las instrucciones, buscar la información en los documentos
correspondientes, reunir los datos necesarios, consignarlos en el formulario y revisarlos. Si usted tiene algún comentario sobre la exactitud de estos cálculos, o alguna
sugerencia sobre cómo mejorar el presente formulario, escriba a la siguiente dirección:
U.S. Department of Education, Washington, DC 20202-4537
Si tiene preguntas sobre el estado de tramitación de su formulario, escriba a la dirección indicada en la Sección 8.




                                                                                   Página 4 de 4
                      IN-SCHOOL DEFERMENT REQUEST                                                                                                             OMB No. 1845-0005
                                                                                                                                                              Form Approved
                      Federal Family Education Loan Program                                                                                                   Exp. Date 05/31/2012

                      WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents is subject to
                      penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.
    SCH
SECTION 1: BORROWER IDENTIFICATION
                                                                                                   Please enter or correct the following information.
                                                                                                   SSN |__|__|__|-|__|__|-|__|__|__|__|
                                                                                                   Name
                                                                                                   Address
                                                                                                   City, State, Zip Code
                                                                                                   Telephone - Home (        )
                                                                                                   Telephone - Other (       )
                                                                                                   E-mail Address (Optional)
SECTION 2: DEFERMENT REQUEST
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 5 and 6.
 I meet the qualifications for the deferment(s) checked below and request that my loan holder defer repayment of my loan(s) (check all that apply):
       While I am enrolled FULL TIME at an eligible school. (For borrowers with any FFEL Program loan.)
       While I am enrolled AT LEAST HALF TIME at an eligible school. (For borrowers who, on the date they signed the promissory note, did not have an outstanding balance on a
       FFEL Program loan made before July 1, 1987; Federal PLUS Loans first disbursed on or after July 1, 2008, are eligible regardless of when the oldest outstanding loan was
       made.)
        If I am a parent borrower of a Federal PLUS Loan first disbursed on or after July 1, 2008, during the 6-month period after I cease to be enrolled at least half time at an eligible
        school.
SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
 I understand that:
   (1) I am not required to make payments of loan principal during my deferment. Interest will not be charged on my subsidized loan(s) during my deferment. However, interest will
       be charged on my unsubsidized loan(s).
   (2) I have the option of paying the interest that accrues on my unsubsidized loan(s) during my deferment.
   (3) I may choose to make interest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period.
          I wish to make interest payments on my unsubsidized loan(s) during my deferment.
   (4) My deferment will begin on the date I began full-time or at least half-time enrollment, as certified by the authorized official who completes Section 4 of this form, and will end on
       the earlier of the date that I cease to meet the enrollment status requirement that qualifies me for the deferment, or the expected ending date of my qualifying enrollment status
       as certified by the authorized official.
   (5) If I am a graduate or professional student Federal PLUS Loan borrower, I will also receive a deferment on my Federal PLUS Loan(s) first disbursed on or after July 1, 2008
       during the 6-month period after I cease to be enrolled on at least a half-time basis.
   (6) If I am a parent borrower of a Federal PLUS Loan first disbursed on or after July 1, 2008 and I request a deferment during the 6-month period after I cease to be enrolled on at
       least a half-time basis, my deferment will begin on the day after I cease to be enrolled at least half time and will end 6 months after that date.
   (7) If my deferment does not cover all my past due payments, my loan holder may grant me a forbearance for all payments due before the begin date of my deferment or—if the
       period for which I am eligible for a deferment has ended—a forbearance for all payments due at the time my deferment request is processed.
   (8) My loan holder may grant me a forbearance on my loans for up to 60 days, if necessary, for the collection and processing of documentation related to my deferment request.
       Interest that accrues during the forbearance will not be capitalized.
 I certify that: (1) The information I provided in Sections 1 and 2 above is true and correct. (2) I will provide additional documentation to my loan holder, as required, to support my
  deferment status. (3) I will notify my loan holder immediately when the enrollment status that qualified me for the deferment ends. (4) I have read, understand, and meet the
  eligibility criteria of the deferment for which I have applied.
 I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to contact me regarding my loan(s), including repayment of my
  loan(s), at the current or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded
  voice or text messages.
Borrower’s Signature                                                                                                                  Date

SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION
NOTE: As an alternative to completing this section, the school may attach its own enrollment certification report listing the required information.
I certify, to the best of my knowledge and belief, that the borrower named above:
(1) is/was enrolled as (check the appropriate box)         a full-time student or      at least a half-time student during the academic period from |__|__|-|__|__|-|__|__|__|__| to
|__|__|-|__|__|-|__|__|__|__| and
(2) is reasonably expected to complete his/her program requirements on |__|__|-|__|__|-|__|__|__|__|.
Name of Institution                                                                                                    OPE-ID
Address                                                                                                                City, State, Zip Code
Name/Title of Authorized Official                                                                                      Telephone (         )
Authorized Official’s Signature                                                                                        Date


                                                                                          Page 1 of 2
SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Report dates as month-day-year (MM-DD-YYYY). For example, ‘January 31, 2009’ = ‘01-31-2009’. An authorized school official must either complete
Section 4 or attach the school’s own enrollment certification report listing the required information. If you need help completing this form, contact your loan holder.
Return the completed form and any required documentation to the address shown in Section 7.
SECTION 6: DEFINITIONS
 An authorized certifying official for an In-School Deferment is an authorized official of the school where I am/was enrolled as a full-time or at least half-time student.
 Capitalization is the addition of unpaid interest to the principal balance of my loan. The principal balance of a loan increases when payments are postponed during periods of
  deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more
  payments may be required. The chart below provides estimates, for a $15,000 unsubsidized loan balance at a 9% interest rate, of the monthly payments due following a 12-month
  deferment. It compares the effects of paying the interest as it accrues, capitalizing the interest at the end of the deferment, and capitalizing interest quarterly and at the end of the
  deferment. My actual loan interest cost will depend on my interest rate, length of the deferment, and frequency of capitalization. Paying interest during the period of deferment
  lowers the monthly payment by about $18 and saves about $772 over the lifetime of the loan, as depicted in the chart below.
              Treatment of Interest Accrued                 Loan         Capitalized Interest    Principal to                                         Monthly            Number of           Total Amount             Total Interest
                      During Deferment                     Amount          for 12 Months           Be Repaid                                          Payment            Payments               Repaid                    Paid
       Interest is paid                                   $15,000.00            $0.00             $15,000.00                                          $190.01               120               $24,151.64*              $9,151.64
       Interest is capitalized at the end of deferment    $15,000.00          $1,350.00           $16,350.00                                          $207.11               120               $24,853.79               $9,853.79
       Interest is capitalized quarterly during
                                                          $15,000.00          $1,396.25           $16,396.25                                           $207.70                120              $24,924.09               $9,924.09
       deferment and at the end of deferment
    *Total amount repaid includes $1,350 of interest paid during the 12-month period of deferment.
 A deferment is a period during which I am entitled to postpone repayment of the principal balance of my loan(s). The federal government pays the interest that accrues during an
  eligible deferment for all subsidized Federal Stafford Loans and for Federal Consolidation Loans for which the Consolidation Loan application was received by my loan holder (1)
  on or after January 1, 1993, but before August 10, 1993, (2) on or after August 10, 1993, if it includes only Federal Stafford Loans that were eligible for federal interest subsidy, or
  (3) on or after November 13, 1997, for that portion of the Consolidation Loan that paid a subsidized FFEL Program loan or a subsidized Federal Direct Loan. I am responsible for
  the interest that accrues during this period on all other FFEL Program loans.
 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal Supplemental Loans for Students (SLS),
  Federal PLUS Loans, and Federal Consolidation Loans.
 Forbearance means permitting the temporary cessation of payments, allowing an extension of time for making payments, or temporarily accepting smaller payments than
  previously scheduled. I am responsible for paying the interest that accrues on my loan(s) during a forbearance. If I do not pay the interest that accrues, the interest may be
  capitalized.
 The holder of my FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the U.S. Department of Education.
SECTION 7: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST
Return the completed deferment request and any required documentation to:                                                If you need help completing this form, call:
(If no address is shown, return to your loan holder.)                                                                    (If no telephone number is shown, call your loan holder.)




SECTION 8: IMPORTANT NOTICES
Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §421 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and the authorities for collecting and using your
Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family Education Loan Program (FFELP) and giving us your SSN are voluntary, but you
must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan (such as a deferment, forbearance, discharge,
or forgiveness) under the FFELP, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and report on your loan(s) if your loan(s) becomes delinquent or in default. We also use your
SSN as an account identifier and to permit you to access your account information electronically.
The information in your file may be disclosed, on a case-by-case basis or under a computer matching program, to third parties as authorized under routine uses in the appropriate systems of records notices. The routine uses
of this information include, but are not limited to, its disclosure to federal, state, or local agencies, to private parties such as relatives, present and former employers, business and personal associates, to consumer reporting
agencies, to financial and educational institutions, and to guaranty agencies in order to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or collection of your loan(s),
to enforce the terms of the loan(s), to investigate possible fraud and to verify compliance with federal student financial aid program regulations, or to locate you if you become delinquent in your loan payments or if you default.
To provide default rate calculations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history information, disclosures may be made to
educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to federal or state agencies. To
provide a standardized method for educational institutions to efficiently submit student enrollment status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in
repayment efforts, disclosures may be made to guaranty agencies, to financial and educational institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to the litigation. If this information, either alone or
with other information, indicates a potential violation of law, we may send it to the appropriate authority for action. We may send information to members of Congress if you ask them to help you with federal student aid
questions. In circumstances involving employment complaints, grievances, or disciplinary actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective bargaining agreement,
we may disclose records to a labor organization recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for the purpose of performing any programmatic function that requires disclosure of
records. Before making any such disclosure, we will require the contractor to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act safeguards.
Paperwork Reduction Notice
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The valid OMB control number for this information
collection is 1845-0005. The time required to complete this information collection is estimated to average 0.16 hours (10 minutes) per response, including the time to review instructions, search existing data resources, gather
and maintain the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, DC 20202-4537
If you have questions regarding the status of your individual submission of this form, write directly to the address shown in Section 7.




                                                                                                             Page 2 of 2
                   SOLICITUD DE APLAZAMIENTO DE PAGO:                                                                                                               N.o de OMB: 1845-0005
                                                                                                                                                                    Formulario aprobado

                   ESTUDIOS                                                                                                                                         Caduca: 31 mayo 2012


                   Federal Family Education Loan ProgramSM
   SCH             AVISO: El que a sabiendas haga declaraciones falsas o engañosas en el presente formulario, o en cualquier documento adjunto al mismo, quedará
                   sujeto a sanciones, las cuales pueden incluir las multas, el encarcelamiento o ambas penas, de conformidad con el Código Penal de EE.UU. y con
                   la Sección 1097 del Título 20 del Código de Estados Unidos.

SECCIÓN 1: DATOS PERSONALES DEL PRESTATARIO
                                                                                                  Favor de introducir o corregir la siguiente información:
                                                                                                  N.o de Seguro Social
                                                                                                  Nombre y apellido
                                                                                                  Dirección
                                                                                                  Ciudad, estado, código postal
                                                                                                  Teléfono (domicilio) (     )
                                                                                                  Teléfono (alternativo) (      )
                                                                                                  Correo electrónico (opcional)
SECCIÓN 2: SOLICITUD DE APLAZAMIENTO DE PAGO
Antes de responder a las preguntas, lea todo el formulario detenidamente, incluyendo las indicaciones y otra información que se hallan en las Secciones 5 y 6.
  Cumplo con los requisitos para acogerme al aplazamiento de pago por los motivos indicados abajo, y solicito que mi acreedor aplace el pago de mis préstamos mientras (marque
  todas las casillas que correspondan):
       Curso ESTUDIOS CON DEDICACIÓN DE TIEMPO COMPLETO en una institución educativa aprobada al efecto. (Para prestatarios que hayan obtenido préstamos
       educativos del Federal Family Education Loan Program [FFELSM].)
       Curso ESTUDIOS CON DEDICACIÓN MÍNIMA DE MEDIO TIEMPO, en una institución educativa aprobada al efecto. (Para prestatarios que, a la fecha de firmar el pagaré
       de sus préstamos, no tenían ningún saldo pendiente de pago en préstamos hechos mediante el Programa FFEL antes del 1 de julio de 1987. Se puede aplazar el pago de
       los Préstamos Federales PLUS que se hayan desembolsado por primera vez el 1 de julio del 2008 o posterior, sin importar la fecha del préstamo más antiguo que quede
       pendiente de pago.)
       Soy el prestatario de algún Préstamo Federal PLUS para padres que se desembolsó por primera vez el 1 de julio del 2008 o posterior. (El pago del préstamo se puede
       aplazar por un período de seis meses posteriores a la fecha de dejar de cursar estudios con una dedicación mínima de medio tiempo en una institución educativa aprobada al
       efecto.)
SECCIÓN 3: ACEPTACIÓN, CERTIFICACIÓN Y AUTORIZACIÓN DEL PRESTATARIO
  Entiendo y acepto lo siguiente:
  (1) No tengo obligación de efectuar pagos al capital del préstamo durante la vigencia del aplazamiento de pago. Durante este período, no se me cobrarán los intereses
      producidos por mis préstamos que tengan subsidio del interés. Sin embargo, se me cobrarán los intereses producidos por mis préstamos que no tengan subsidio del interés.
   (2) Tengo la opción de pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
   (3) Puedo optar por pagar el interés, marcando la casilla de abajo. Mi acreedor podrá capitalizar los intereses que no se paguen durante el período de aplazamiento.
          Deseo pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
   (4) El aplazamiento de pago entrará en vigor en la fecha de inicio de los estudios con dedicación de tiempo completo o con dedicación mínima de medio tiempo, según certifique
       esta fecha el funcionario o empleado autorizado que llene la Sección 4 del presente formulario. El aplazamiento vencerá en la primera de las dos fechas siguientes: la fecha
       en que deje de cursar estudios con el régimen de dedicación que justificó tal beneficio o la fecha prevista de terminación de dichos estudios, según certifique la fecha el
       funcionario o empleado autorizado.
   (5) Si obtuve Préstamos Federales PLUS para pagar mis estudios de posgrado, también se aplazará el pago de los que se hayan desembolsado el 1 de julio del 2008 o posterior,
       durante los seis meses siguientes a dejar de cursar estudios con una dedicación mínima de medio tiempo.
   (6) Si para pagar los estudios de alguno de mis hijos obtuve Préstamos Federales PLUS que se desembolsaron por primera vez el 1 de julio del 2008 o posterior, y solicito el
       aplazamiento de pago durante los seis meses siguientes a dejar de cursar estudios con una dedicación mínima de medio tiempo, el período de aplazamiento empezará el día
       siguiente al día en que haya dejado de cursar estudios con una dedicación mínima de medio tiempo y terminará seis meses después de esa fecha.
   (7) Si el aplazamiento de pago no abarca todas las cuotas atrasadas, mi acreedor puede concederme un período de indulgencia de morosidad que abarque las que hayan
       vencido antes de la fecha de entrada en vigor del aplazamiento. En caso de que haya terminado el período de vigencia del aplazamiento, mi acreedor puede otorgarme un
       período de indulgencia que abarque toda cuota que haya vencido hasta la fecha de tramitación de la presente solicitud.
   (8) Mi acreedor puede concederme, según sea necesario, un período de indulgencia de morosidad por una duración máxima de 60 días, por motivo de la recopilación y
       tramitación de los documentos relativos a mi solicitud de aplazamiento de pago. No se capitalizarán los intereses producidos durante el plazo de vigencia de este tipo de
       indulgencia.
  Certifico lo siguiente: (1) que la información que proporcioné en las Secciones 1 y 2, arriba, es correcta y verídica; (2) que aportaré documentación complementaria a mi
  acreedor, según sea necesario, que acredite las circunstancias en cuya virtud me acojo al aplazamiento de pago; (3) que avisaré a mi acreedor, de forma inmediata, una vez que
  deje de cursar estudios con el régimen de dedicación que justificó el aplazamiento de pago, y (4) que he leído, entendido y cumplido los requisitos y condiciones cuya satisfacción
  es necesaria para la concesión del aplazamiento de pago por los motivos señalados en el presente formulario de solicitud.
  Autorizo a la institución educativa, al acreedor, al garante, al Departamento y a sus respectivos agentes y contratistas a comunicarse conmigo respecto a mis préstamos, incluido
  el pago de los mismos, al número actual o futuro (si lo proporciono) de mi teléfono móvil u otro dispositivo inalámbrico, por medio de sistemas de marcado automático, mensajes
  de texto o mensajes de voz artificial o grabados.


Firma del prestatario                                                                                                                   Fecha




                                                                                       Página 1 de 3
SECCIÓN 4: CERTIFICACIÓN DEL FUNCIONARIO O EMPLEADO AUTORIZADO
NOTA: En lugar de rellenar la presente sección, la institución puede adjuntar su propia certificación de la dedicación y fechas de estudio.
Certifico que, según mi leal saber y entender, el prestatario arriba indicado:
(1) está o estuvo matriculado para cursar estudios (marque la casilla correspondiente)        con dedicación de tiempo completo o           con una dedicación mínima de medio tiempo,
durante el período académico comprendido entre el                                           y el                                            , y que también
(2) se prevé, con un grado razonable de confiabilidad, que cumpla el programa de estudios el                                            .
Nombre de la institución                                                                                        OPE-ID

Dirección                                                                                                        Ciudad, estado, código postal

Nombre, apellido y puesto del
funcionario o empleado autorizado                                                                               Teléfono (          )

Firma del funcionario o
empleado autorizado                                                                                             Fecha


SECCIÓN 5: INSTRUCCIONES PARA LLENAR EL FORMULARIO
Escriba sus respuestas a máquina o con letra de molde y tinta oscura. Escriba las fechas en el formato mes-día-año (MM-DD-AAAA). Por ejemplo, «31 de enero de 2009» equivale a
«01-31-2009». El funcionario o empleado autorizado deberá rellenar la Sección 4 o adjuntar la certificación de dedicación de estudio, facilitada por la institución educativa, en la que
figure la información necesaria. Si usted necesita ayuda para llenar el presente formulario, comuníquese con su acreedor.
Remita el formulario con los datos completos, y cualquier documentación solicitada, a la dirección indicada en la Sección 7.
SECCIÓN 6: DEFINICIONES
    El acreedor de mis préstamos del Programa FFEL puede ser una entidad prestamista, garante o financiera (del mercado secundario), o el Departamento de Educación de EE.UU.
    El aplazamiento de pago consiste en un período durante el cual tengo derecho a posponer el pago del capital de mis préstamos. El Departamento de Educación de EE.UU.
    sufraga los intereses producidos durante el aplazamiento de pago debidamente tramitado, todo Préstamo Federal Stafford con subsidio del interés y todo Préstamo Federal de
    Consolidación cuya solicitud llegó a mi acreedor (1) el 1 de enero de 1993 o posterior pero antes del 10 de agosto de 1993, (2) el 10 de agosto de 1993 o posterior, siempre que
    la solicitud incluyera sólo los Préstamos Federales Stafford que gozaban del subsidio federal del interés, o (3) el 13 de noviembre de 1997 o posterior, cuando se trate de la
    porción del préstamo de consolidación con la que se liquidó un préstamo educativo con subsidio del interés obtenido del Programa FFEL o del Direct Loan ProgramSM. Tengo la
    responsabilidad de pagar los intereses producidos durante este período por cualquier otro préstamo hecho al amparo del Programa FFEL.
   La capitalización consiste en añadir los intereses pendientes de pago al saldo de capital del préstamo. El saldo de capital del préstamo aumenta cuando se postergan los pagos,
   durante los períodos de aplazamiento de pago o de indulgencia de morosidad, y se capitalizan los intereses. Como resultado de esto, puede que se produzcan más intereses
   durante la vigencia del préstamo, que se aumente la cantidad de la cuota mensual o que se incremente el número de los pagos. En el cuadro siguiente, se presentan cálculos
   aproximados de las cuotas mensuales de un préstamo sin subsidio del interés, hecho por un monto de $15,000 y con una tasa de 9 por ciento, después de un período de aplaza-
   miento de pago de 12 meses de duración. Se comparan los efectos de las diferentes maneras de tratar los intereses del préstamo: pagarlos a medida que se van produciendo,
   capitalizarlos al final del período de aplazamiento de pago y capitalizarlos trimestralmente y al final del período de aplazamiento de pago. El costo efectivo de los intereses de mi
   préstamo dependerá de la tasa de interés, de la duración del aplazamiento de pago y de la frecuencia de capitalización de los intereses. Como se puede apreciar en el cuadro, si
   los intereses se van pagando durante el período del aplazamiento de pago, la cuota mensual se rebaja en unos $18 y se ahorran casi $772 durante la vigencia del préstamo.
       Tratamiento de los intereses producidos          Cantidad del       Intereses capitalizados       Capital a        Cuota              Número                     Total pagado
                                                                                                                                                        Total pagado
             durante el aplazamiento de pago             préstamo                (12 meses)               pagar          mensual            de cuotas                   en intereses
      Pagar los intereses durante
                                                         $15,000.00                 $0.00                $15,000.00       $190.01             120        $24,151.64*      $9,151.64
      el aplazamiento de pago
      Capitalizar los intereses al final
                                                         $15,000.00               $1,350.00              $16,350.00       $207.11             120         $24,853.79      $9,853.79
      del aplazamiento de pago
      Capitalizar los intereses cada
       trimestre durante el aplazamiento                 $15,000.00               $1,396.25              $16,396.25       $207.70             120         $24,924.09      $9,924.09
      de pago y al final del mismo
   * El total pagado incluye los $1,350 de intereses pagados durante los 12 meses del aplazamiento de pago.
   El Federal Family Education Loan Program (Programa FFEL) incluye los Préstamos Federales Stafford (con y sin subsidio del interés), los Préstamos Federales
   Suplementarios para Estudiantes (SLS), los Préstamos Federales PLUS y los Préstamos Federales de Consolidación.
   Funcionario y empleado autorizado para certificar los datos consignados se refiere, para efectos del presente formulario, al funcionario o empleado autorizado de la
   institución educativa en la que curso o cursé estudios con dedicación de tiempo completo o con una dedicación mínima de medio tiempo.
   Indulgencia de morosidad se refiere a la suspensión temporal de las cuotas del préstamo, a la prolongación del plazo de vencimiento de las cuotas o a la reducción temporal de
   la cantidad programada de las cuotas. Tengo la responsabilidad de pagar los intereses producidos por mis préstamos durante el período de indulgencia de morosidad. Si no
   pago los intereses, éstos pueden capitalizarse.




                                                                                   Página 2 de 3
SECCIÓN 7: DÓNDE ENVIAR EL FORMULARIO CON LOS DATOS COMPLETOS
Envíe el formulario con los datos completos, y cualquier otra documentación necesaria, a      Si necesita ayuda para llenar el formulario, llame al siguiente número:
la siguiente dirección:                                                                       (De no indicarse ningún número de teléfono, llame a su acreedor.)
(De no indicarse ninguna dirección, remita el formulario a su acreedor.)




SECCIÓN 8: AVISOS IMPORTANTES
Aviso sobre la Ley de Confidencialidad de Información
En virtud de la Ley de Confidencialidad de Información de 1974 (Sección 552a del Título 5 del Código de Estados Unidos), es obligatorio poner a disposición del solicitante el
siguiente aviso:
La autoridad para reunir la información solicitada por medio del presente formulario deriva de la Sección 421 y siguientes de la Ley de Educación Superior de 1965, según
enmendada (Sección 1071 y siguientes del Título 20 del Código de Estados Unidos). La autoridad para solicitar y utilizar el número de Seguro Social del solicitante deriva de la
Sección 484(a)(4) de la Ley de Educación Superior (Sección 1091[a][4] del Título 20 del Código de Estados Unidos) y de la Sección 7701(b) del Título 30 del Código de Estados
Unidos. Si bien tienen carácter voluntario tanto la participación en el Federal Family Education Loan Program (Programa FFEL) como el proporcionar el número de Seguro Social, el
solicitante deberá facilitar la información solicitada, incluido el número de Seguro Social, para poder participar en el Programa.
La reunión de la información solicitada en el presente formulario (incluido el número de Seguro Social) se realiza con los siguientes fines principales: verificar la identidad del
solicitante; determinar el otorgamiento, al amparo del Programa FFEL, de préstamos nuevos o de beneficios en materia del pago de préstamos existentes (como por ejemplo, el
aplazamiento de pago, la indulgencia de morosidad, y la anulación o condonación de deudas); administrar los préstamos del solicitante, y, en caso de mora o incumplimiento de
pago, localizarlo, exigirle el pago de la deuda e informar a las entidades competentes la condición de los préstamos. También hacemos uso del número de Seguro Social como
identificador de la cuenta de préstamos del solicitante y para permitir a éste acceder electrónicamente a los datos relativos a la misma.
Al amparo de una cláusula, debidamente publicada en el sistema de registro de datos correspondiente, relativa al uso normal de la información recogida, los datos que se encuentran
en el expediente del solicitante se pueden poner a disposición de terceras entidades, ya sea según las circunstancias particulares del caso o en cumplimiento de un programa de
cotejo electrónico de datos. Tratándose del presente formulario, el uso normal de esta información incluye, sin carácter limitativo, la cesión de los datos a ciertas partes, señaladas
abajo, a fin de hacer lo siguiente: verificar la identidad del solicitante; determinar el otorgamiento de préstamos nuevos o de beneficios en materia del pago de préstamos existentes;
permitir la administración o cobro de los préstamos; hacer cumplir los términos y condiciones de los préstamos; investigar la posible comisión de fraude y verificar el cumplimiento de
las normas que rigen los programas federales de ayuda económica para los estudios superiores o localizar al solicitante en caso de mora o incumplimiento de pago. Las siguientes
son las partes a las que podemos destinar la información reunida: organismos federales, estatales y locales; particulares que tienen alguna relación con el solicitante, tales como
familiares, empleadores actuales y pasados, socios comerciales y personales; agencias de informes crediticios; instituciones educativas y financieras, y garantes. Para informar
sobre los cálculos del índice de incumplimiento de pago, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos estatales. Para facilitar el
historial de ayuda económica del solicitante, podemos ceder los datos a instituciones educativas. Para ayudar a los administradores del programa a llevar un control sobre la
devolución de fondos de préstamo y la anulación de préstamos, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos federales o estatales.
Para establecer un método estandarizado según el cual instituciones educativas puedan informar de forma eficiente sobre la dedicación de estudio del solicitante, podemos ceder los
datos a garantes o a instituciones financieras y educativas. Para dar orientación al solicitante en materia del pago de préstamos, podemos ceder los datos a garantes, a instituciones
financieras y educativas, o a organismos federales, estatales o locales.
En caso de litigio, podemos enviar los datos del solicitante al Departamento de Justicia, o al tribunal, entidad jurídica, abogado, parte o testigo correspondientes, cuando dicha cesión
se considere procedente y necesaria para la solución del mismo. Si estos datos, ya sean por separado o en conjunto con otra información, indican una posible violación de la ley,
podemos enviarlos a las autoridades competentes, para que se tomen las medidas pertinentes. Podemos enviar la información a congresistas en caso que usted les pida ayuda con
algún problema relacionado con los programas federales de asistencia estudiantil. En caso de denuncias, quejas o medidas disciplinarias en materia de empleo, podemos ceder los
datos a las entidades competentes, a fin de facilitar la adjudicación o investigación de las mismas. Si así se dispone en una convención colectiva de trabajo, podemos ceder los
datos a los sindicatos debidamente reconocidos al amparo del Capítulo 71 del Título 5 del Código de Estados Unidos. Podemos poner los datos a disposición de nuestros
contratistas si los necesitan para realizar funciones relacionadas con los programas en referencia. Antes de hacerlo, requerimos que el contratista ponga en práctica las medidas de
protección necesarias para cumplir con la Ley de Confidencialidad de Información. Los datos también pueden cederse, de conformidad con las protecciones previstas en la Ley de
Confidencialidad de Información, a aquellos investigadores que reúnan los requisitos correspondientes.
Aviso sobre la Ley de Reducción de Trámites
Según lo dispuesto en la Ley de Reducción de Trámites de 1995, ninguna persona estará en la obligación de responder a un instrumento de recolección de datos que no exhiba un
número de control vigente emitido por la Oficina de Administración y Presupuesto (OMB, por sus siglas en inglés). Para efectos del presente formulario, dicho número es 1845-0005.
Se calcula que se necesitan, como promedio, 0.16 horas (10 minutos) por respuesta, incluido el tiempo para leer las instrucciones, buscar la información en los documentos
correspondientes, reunir los datos necesarios, consignarlos en el formulario y revisarlos. Si usted tiene algún comentario sobre la exactitud de estos cálculos, o alguna
sugerencia sobre cómo mejorar el presente formulario, escriba a la siguiente dirección:
U.S. Department of Education, Washington, DC 20202-4537
Si tiene preguntas sobre el estado de tramitación de su formulario, escriba a la dirección indicada en la Sección 7.




                                                                                   Página 3 de 3
               MILITARY DEFERMENT REQUEST                                                                                                                 OMB No. 1845-0080
                                                                                                                                                          Form Approved
               Federal Family Education Loan Program / William D. Ford Federal Direct Loan Program / Federal Perkins Loan Program                         Exp. Date 04/30/2010
               Use this form only for Federal Family Education Loan Program, William D. Ford Federal Direct Loan Program, or Federal Perkins Loan
               Program loans first disbursed on or after July 1, 2001, and Federal Consolidation Loans or Direct Consolidation Loans only if all of the
    MIL        Title IV loans included in the Consolidation Loan were first disbursed on or after July 1, 2001.
               WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents
               will be subject to penalties which may include fines, imprisonment or both, under the U.S. Criminal Code and 20 U.S.C. 1097.

SECTION 1: BORROWER IDENTIFICATION
                                                                                         Please enter or correct the following information.
                                                                                         SSN
                                                                                         Name _________________________________________________________
                                                                                         Address ________________________________________________________
                                                                                         City, State, Zip ___________________________________________________
                                                                                         Telephone - Home (       ) _________________________________________
                                                                                         Telephone - Other (       ) _________________________________________
                                                                                         E-mail Address (Optional) __________________________________________

SECTION 2: DEFERMENT REQUEST
Carefully read the entire form, including the instructions and other information in Sections 5, 6, and 7. A representative may complete and sign this form
on your behalf if you are unable to do so.
n I meet the qualifications stated in Section 7 for this deferment and request that my loan holder defer repayment of my eligible loan(s) for a period not to
  exceed three years while I am either:
  • Serving on active duty during a war or other military operation or national emergency, as defined in Section 6, or
   • Performing qualifying National Guard duty during a war or other military operation or national emergency, as defined in Section 6.

SECTION 3: BORROWER UNDERSTANDINGS AND CERTIFICATIONS
n I understand that:
   (1) I am not required to make payments of loan principal during my deferment. Interest will not be charged on my subsidized FFEL or Direct Loan
         program loan(s) or Perkins Loan Program loan(s) during my deferment. However, interest will be charged on my unsubsidized FFEL and Direct
         Loan program loan(s).
   (2) I have the option of paying the interest on my unsubsidized FFEL or Direct Loan program loan(s) during my deferment.
   (3) My loan holder may capitalize interest that I do not pay during the deferment period on my unsubsidized FFEL or Direct Loan program loan(s).
   (4) My deferment will begin on the date I began performing the military service that qualifies me for the deferment, as certified by an authorized official or
         documented by my military orders.
   (5) My deferment will end on the earlier of (a) the date that I stop performing the military service that qualifies me for the deferment, (b) the ending date of
         my qualifying military service, as certified by an authorized official or documented by my military orders, or (c) the date on which my loan reaches the
         maximum period of deferment under the law. The total military deferment period may not exceed three years for any eligible loan.
   (6) If my deferment does not cover all my past due payments, my loan holder may grant me a forbearance for all payments due before the begin date
         of my deferment or—if the period for which I am eligible for a deferment has ended—a forbearance for all payments due at the time my deferment
         request is processed.
   (7) During the deferment period on my eligible loans, I may request a forbearance on my other FFEL, Direct Loan or Perkins Loan program loans that are
         not eligible for this deferment.
   (8) My loan holder may capitalize unpaid interest that accrues during a forbearance period on a FFEL or Direct Loan program loan, and this will increase
         the principal balance of the loan. Unpaid interest that accrues on a Perkins Loan Program loan during a forbearance period is not capitalized.
   (9) My loan holder may grant me a forbearance on my FFEL or Direct Loan program loan(s) for up to 60 days, if necessary, for the collection and
         processing of documentation related to my deferment request. Interest that accrues during this forbearance period will not be capitalized.
n I certify that: (1) The information I provided in Section 1 above is true and correct. (2) I will provide additional documentation to my loan holder, as required,
  to support my eligibility for this deferment. (3) I will notify my loan holder immediately if I stop performing the military duty that qualifies me for this
  deferment or I otherwise become ineligible for this deferment. (4) I have read, understand, and meet the eligibility criteria for this deferment, as stated in
  Section 2 and explained in Section 7.
Signature of Borrower or Borrower’s Representative _____________________________________________ Date ________________________________
Printed Name of Borrower’s Representative (if applicable) __________________________________________ Relationship to Borrower ________________
Address of Borrower’s Representative __________________________________________________________ Telephone (                                        ) _____________________

SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION
Note: As an alternative to completing this section, a written statement from the commanding or personnel officer or a copy of the military orders may be attached.
I certify, to the best of my knowledge and belief, that the borrower named above is/was engaged in the service described in Sections 2, 6, and 7 that
begins/began on                                              and ends/ended on                                                  . Enter dates as month-day-year (mm-dd-yyyy).

Name of Military Branch or National Guard ____________________________________________________________________________________________
Address _________________________________________________________________ City, State, Zip _________________________________________
Name/Title of Authorized Official ______________________________________________ Telephone (                                ) ______________________________________
Authorized Official’s Signature _______________________________________________ Date _________________________________________________

                                                                                  Page 1 of 3
SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Use only numbers. Example: January 1, 2008 = 01-01-2008. In order to establish
your eligibility, (1) an authorized official must complete section 4, or (2) a copy of your military orders or a written statement from your commanding or
personnel officer must be attached. If you need help completing this form, contact your loan holder. If you are applying for a deferment of loans that are held
by different loan holders, you must submit a separate deferment request to each loan holder.
Return the completed form and any required documentation to the address shown in Section 8.

SECTION 6: DEFINITIONS
n   Active duty means full-time duty in the active military service of the United States as defined in 10 U.S.C. 101(d)(1), but does not include training or
    attendance at a service school.
n   An authorized certifying official is my commanding or personnel officer.
n   Capitalization is the addition of unpaid interest to the principal balance of my FFEL or Direct Loan program loan. This will increase the principal and total
    cost of my loan.
n   A deferment is a period during which I am entitled to temporarily postpone making payments on the principal balance of my loan(s). Interest is not
    charged during a deferment on subsidized FFEL or Direct Loan program loans, or on Perkins Loan Program loans. Interest is charged during a deferment
    on unsubsidized FFEL and Direct Loan program loans.
n   The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal PLUS Loans, and
    Federal Consolidation Loans.
n   The Federal Perkins Loan (Perkins Loan) Program includes Federal Perkins Loans, National Direct Student Loans (NDSL), and National Defense Student
    Loans (Defense Loan).
n   The William D. Ford Federal Direct Loan (Direct Loan) Program includes Federal Direct Stafford/Ford (Direct Subsidized) Loans, Federal Direct
    Unsubsidized Stafford/Ford (Direct Unsubsidized) Loans, Federal Direct PLUS (Direct PLUS) Loans, and Federal Direct Consolidation (Direct Consolidation)
    Loans.
n   Forbearance means permitting the temporary cessation of payments, allowing an extension of time for making payments, or temporarily accepting smaller
    payments than scheduled. I am responsible for paying the interest that accrues on my loans during a forbearance. If I do not pay the interest that accrues
    on a FFEL or Direct Loan program loan during forbearance, it may be capitalized. Unpaid interest that accrues on a Perkins Loan Program loan during a
    forbearance is not capitalized.
n   The holder of my FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the U.S. Department of Education (ED). The holder of my
    Direct Loan Program loan(s) is ED. The holder of my Perkins Loan Program loan(s) may be a school or ED.
n   Military operation means a contingency operation as defined in 10 U.S.C. 101(a)(13). A contingency operation is a military operation that (1) is
    designated by the U.S. Secretary of Defense as an operation in which members of the Armed Forces are or may become involved in military actions,
    operations, or hostilities against an enemy of the U.S. or against an opposing military force; or (2) results in the call or order to, or retention on, active duty
    of members of the uniformed services under 10 U.S.C. 688, 12301(a), 12302, 12304, 12305, or 12406; 10 U.S.C. Chapter 15; or any other provision of law
    during a war or during a national emergency declared by the President or Congress.
n   National emergency means the national emergency by reason of certain terrorist attacks declared by the President on September 14, 2001, or subsequent
    national emergencies declared by the President by reason of terrorist attacks.
n   Qualifying National Guard duty during a war or other operation or national emergency means training or other duty, other than inactive, performed by a
    member of the National Guard on full-time National Guard duty, as defined in 10 U.S.C. 101(d)(5), under a call to active service authorized by the President
    or the Secretary of Defense. The training or other duty must be performed for more than 30 consecutive days under 32 U.S.C. 502(f) in connection with a
    war, other military operation, or national emergency as declared by the President and supported by federal funds.
n   Serving on active duty during a war or other military operation or national emergency means service by an individual who is (1) a Reserve of an Armed
    Force ordered to active duty under 10 U.S.C. 12301(a), 12301(g), 12302, 12304, or 12306; or (2) a retired member of an Armed Force ordered to active
    duty under 10 U.S.C. 688 for service in connection with a war or other military operation or national emergency, regardless of the location at which the
    active duty service is performed; or (3) any other member of an Armed Force on active duty in connection with the emergency or subsequent actions or
    conditions who has been assigned to a duty station at a location other than the location where the member is normally assigned.
n   Title IV loans include loans made under the FFEL, Direct Loan, and Perkins Loan programs.

SECTION 7: ELIGIBILITY CRITERIA FOR MILITARY DEFERMENT

 A military deferment is available only for:
  • Federal Stafford Loans (both subsidized and unsubsidized), Federal PLUS Loans, Direct Subsidized Loans, Direct Unsubsidized Loans, Direct PLUS Loans,
    and Federal Perkins Loans, that were first disbursed on or after July 1, 2001, and
  • Federal Consolidation Loans and Direct Consolidation Loans, only if all of my Title IV loans included in the consolidation loan were first disbursed
    on or after July 1, 2001.
 I may defer repayment of my eligible loan(s) for a maximum of 3 years while I am:
  • Serving on active duty during a war or other military operation or national emergency. I must provide my loan holder with a copy of my military orders or a
    written statement from my commanding or personnel officer, or I must have my commanding or personnel officer certify Section 4 on this form; or
  • Performing qualifying National Guard duty during a war or other military operation or national emergency. I must provide my loan holder with a copy of
    my military orders or a written statement from my commanding or personnel officer, or I must have my commanding or personnel officer certify Section 4
    on this form.




                                                                             Page 2 of 3
SECTION 8: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST
Return the completed deferment request and any required documentation to:            If you need help completing this form, call:
(If no address is shown, return to your loan holder.)                                (If no telephone number is shown, call your loan holder.)




SECTION 9: IMPORTANT NOTICES
Privacy Act Notice. The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §421 et seq., §451 et seq., and/or §461 et seq. of the Higher Education Act (HEA)
of 1965, as amended (20 U.S.C. 1071 et seq., 20 U.S.C. 1087a et seq., and/or 20 U.S.C. 1087aa et seq.), and the authorities for collecting and using your Social
Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family Education Loan (FFEL)
Program, William D. Ford Federal Direct Loan (Direct Loan) Program, and Federal Perkins Loan (Perkins) Program and giving us your SSN are voluntary, but
you must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan
or a benefit on a loan (such as a deferment, forbearance, discharge, or forgiveness) under the FFEL Program, Direct Loan Program, and/or Perkins Program, to
permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and report on your loan(s) if your loan(s) become delinquent or in
default. We also use your SSN as an account identifier and to permit you to access your account information electronically.
The information in your file may be disclosed, on a case-by-case basis or under a computer matching program, to third parties as authorized under routine
uses in the appropriate systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local
agencies, to private parties such as relatives, present and former employers, business and personal associates, to consumer reporting agencies, to financial
and educational institutions, and to guaranty agencies in order to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan, to
permit the servicing or collection of your loan(s), to enforce the terms of the loan(s), to investigate possible fraud and to verify compliance with federal student
financial aid program regulations, or to locate you if you become delinquent in your loan payments or if you default. To provide default rate calculations,
disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history information,
disclosures may be made to educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made
to guaranty agencies, to financial and educational institutions, or to federal or state agencies. To provide a standardized method for educational institutions
to efficiently submit student enrollment status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in
repayment efforts, disclosures may be made to guaranty agencies, to financial and educational institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant
and necessary to the litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate
authority for action. We may send information to members of Congress if you ask them to help you with federal student aid questions. In circumstances
involving employment complaints, grievances, or disciplinary actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for
by a collective bargaining agreement, we may disclose records to a labor organization recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our
contractors for the purpose of performing any programmatic function that requires disclosure of records. Before making any such disclosure, we will require
the contractor to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act safeguards.
Paperwork Reduction Notice. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a currently valid OMB control number. The valid OMB control number for this information collection is 1845-0080. The time required to complete this
information collection is estimated to average 0.5 hours (30 minutes) per response, including the time to review instructions, search existing data resources,
gather and maintain the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time
estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education
Washington, DC 20202-4700


If you have questions regarding the status of your individual submission of this form, contact your loan holder (see Section 8).




                                                                             Page 3 of 3
                  SOLICITUD DE APLAZAMIENTO POR SERVICIO MILITAR
                  Programa Federal de Préstamos para Educación de la Familia / Programa Federal de Préstamos Directos William D. Ford /                                  OMB No. 1845-0080
                                                                                                                                                                         Form Approved
                  Programa Federal de Préstamos Perkins                                                                                                                  Exp. Date 04/30/2010
                  Use este formulario únicamente para los préstamos del Programa Federal de Préstamos de Educación para la Familia, Programa Federal de
                  Préstamos Directos William D. Ford, o el Programa Federal de Préstamos Perkins que se desembolsaron el 1º de julio de 2001, o después de
                  esa fecha, y para los Préstamos Federales de Consolidación o Préstamos Directos de Consolidación solamente si todos los préstamos del
    MIL           Título IV incluidos en el Préstamo de Consolidación fueron desembolsados por primera vez el 1º de julio de 2001, o después de esa fecha.
                  ADVERTENCIA: Cualquier persona que a sabiendas proporcione información o declaraciones falsas en este formulario o en cualquier documento adjunto,
                  estará sujeta a sanciones que pueden incluir multas, encarcelamiento o ambos, según el Código Penal de EE.UU. y 20 U.S.C. 1097.
SECCIÓN 1: IDENTIFICACIÓN DEL PRESTATARIO
Apellido                             Primer nombre                           Inicial del segundo nombre            Número de seguro social


Dirección: calle                                                                                                   Código de área/número de teléfono
                                                                                                                   (      )
                                                                                                                   Código de área/número de teléfono (otro)
Ciudad                               Estado                                                   Código postal
                                                                                                                   (      )
                                                                                                                   Dirección de mail (opcional)

SECCIÓN 2: SOLICITUD DE APLAZAMIENTO
Lea detenidamente todo el formulario, incluidas las instrucciones y demás información que aparece en las Secciones 5, 6 y 7. Un representante puede llenar y firmar
este formulario en su nombre si usted no lo puede hacer.
   Reúno todas las condiciones estipuladas en la Sección 7 de este aplazamiento y solicito que el titular de mi préstamo aplace los pagos de mis préstamos elegibles durante
    periodo que no excedan los tres años mientras me encuentro:
            Prestando servicio activo durante una guerra o cualquier otra operación militar o emergencia nacional, según lo definido en la Sección 6, o bien
            Prestando servicio habilitante para la Guardia Nacional durante una guerra o cualquier otra operación militar o emergencia nacional, según lo definido en la Sección 6.
SECCIÓN 3: COMPROMISO Y CERTIFICACIONES DEL PRESTATARIO
   Me consta que:
   (1)    No tengo la obligación de efectuar pagos del capital del préstamo durante el periodo de aplazamiento. No me cobrarán intereses por mi(s) préstamo(s) con subsidio de los
          programas FFEL o Préstamos Directos ni por los préstamos del Programa de Préstamos Perkins durante mi periodo de aplazamiento. Sin embargo, me cobrarán intereses
          por mi(s) préstamo(s) sin subsidio de los programas FFEL y Préstamos Directos.
   (2)    Tengo la opción de pagar los intereses por mi(s) préstamo(s) sin subsidio de los programas FFEL o Préstamos Directos durante mi periodo de aplazamiento.
   (3)    El titular de mis préstamos podría capitalizar los intereses que no pague durante el periodo de aplazamiento por mi(s) préstamo(s) sin subsidio de los programas FFEL o
          Préstamos Directos.
   (4)    Mi aplazamiento comenzará en la fecha en que empiece a prestar servicios militares que me habiliten para recibir el aplazamiento, según lo certificado por un oficial
          autorizado o documentado por mis órdenes militares.
   (5)    Mi periodo de aplazamiento finalizará cuando ocurra lo primero de lo siguiente: (a) la fecha en que deje de prestar el servicio militar que me habilite para recibir el
          aplazamiento, (b) la fecha en que finalice mi servicio militar habilitante, según lo certificado por un oficial autorizado o documentado por mis órdenes militares, o (c) la fecha
          en que mi préstamo llegue a cumplir el periodo máximo de aplazamiento permitido por ley. El total del periodo de aplazamiento por servicio militar no podrá exceder los
          tres años para cualquier préstamo elegible.
   (6)    Si el aplazamiento no abarca todos mis pagos vencidos, el titular del préstamo podría otorgarme indulgencia para todos los pagos que deba hacer antes de la fecha inicial
          de mi aplazamiento, o bien, si hubiera finalizado el periodo para el cual puedo recibir el aplazamiento, indulgencia para todos los pagos que debiera hacer para la fecha en
          que se tramite mi solicitud de aplazamiento.
   (7)    Durante el periodo de aplazamiento para los préstamos elegibles, podría solicitar indulgencia para mis otros préstamos de los programas FFEL, Préstamos Directos o
          Perkins que no sean elegibles para este aplazamiento.
   (8)    El titular de mis préstamos podría capitalizar los intereses por pagar que se acumulen durante el periodo de indulgencia por algún préstamo del programa FFEL o Préstamo
          Directo, y ello incrementará el saldo principal del préstamo. Los intereses por pagar que se acumulen en un préstamo del Programa de Préstamos Perkins durante el
          periodo de indulgencia no se capitalizan.
   (9)    El titular del préstamo podría otorgarme una indulgencia de hasta 60 días por los préstamos que tenga de los Programas FFEL o Préstamos Directos, si fuera necesario,
          para el cobro y la tramitación de la documentación relacionada con mi solicitud de aplazamiento. Los intereses que se acumulen durante este periodo de indulgencia no se
          capitalizarán.
   Certifico que: (1) la información que he proporcionado en la Sección 1 anterior es fidedigna y correcta. (2) voy a proporcionar documentación adicional al titular de mi préstamo,
   según sea necesario, para documentar que reúno los requisitos para recibir este aplazamiento. (3) notificaré al titular de mi préstamo de inmediato si dejo de prestar el tipo de
   servicio militar que me habilite a recibir este aplazamiento o si por algún otro motivo dejo de reunir los requisitos necesarios para que me otorguen este aplazamiento. (4) He
   leído, entiendo y reúno los requisitos necesarios para recibir este aplazamiento, según lo indicado en la Sección 2 y explicado en la Sección 7.
Firma del prestatario o del representante del prestatario                                                                          Fecha
Aclaración del nombre del representante del prestatario (si corresponde)                                                           Relación con el prestatario
Dirección del representante del prestatario                                                                                        Teléfono (           )
SECCIÓN 4: CERTIFICACIÓN DEL FUNCIONARIO AUTORIZADO
Nota: En vez de llenar esta sección, se puede adjuntar una declaración expresa del comandante u oficial de personal, o bien una copia de la orden militar.
Certifico, según mi leal saber y entender, que el prestatario antes nombrado está/estuvo vinculado con el servicio que se describe en las Secciones 2, 6, y 7 que empieza/empezó el
|__|__|-|__|__|-|__|__|__|__|                  y termina/terminó el   |__|__|-|__|__|-|__|__|__|__|.                   Indique las fechas en el formato mes-día-año (mm-dd-aaaa).
Nombre de la Repartición Militar o Guardia Nacional
Dirección                                                                                                                     Ciudad, estado, cód.postal
Nombre/Cargo del Funcionario Autorizado                                                                                       Teléfono (            )
Firma del oficial autorizado                                                                                                  Fecha

                                                                                            Pág. 1 de 3
SECCIÓN 5: INSTRUCCIONES PARA LLENAR EL FORMULARIO
Escriba a máquina o en letra de molde usando tinta negra. Indique las fechas en el formato mes-día-año (mm-dd-aaaa). Use números solamente. Ejemplo: 1 de enero de 2008 =
01-01-2008. A efectos de determinar su elegibilidad, (1) un oficial autorizado tiene que llenar la sección 4, o bien (2) deberá adjuntar una copia de sus órdenes militares o una
declaración escrita de su comandante u oficial de personal. Si necesita ayuda para llenar este formulario, comuníquese con el titular de su préstamo. Si solicita el aplazamiento
para préstamos que tengan más de un titular, deberá presentar una solicitud separada de aplazamiento por cada uno de los titulares de préstamos.
Envíe el formulario completo y los documentos adjuntos a la dirección que se indica en la Sección 8.

SECCIÓN 6: DEFINICIONES
    Por servicio activo se entiende servicio a tiempo completo en alguna de las fuerzas militares activas de Estados Unidos según lo definido en 10 U.S.C. 101(d)(1), pero no
    incluye capacitación o asistencia a alguna escuela de la fuerza que sea.
    El oficial certificante autorizado es el comandante u oficial de personal.
    Capitalización es la suma de los intereses no pagados al saldo del capital del préstamo del préstamo del programa FFEL o de Préstamos Directos. Ello incrementa el capital y
    el costo total del préstamo.
    Aplazamiento es el periodo durante el cual tengo derecho a posponer temporalmente los pagos correspondientes al saldo del capital de mi(s) préstamo(s). No se cobran
    intereses durante un aplazamiento de préstamos con subsidio de los programas FFEL o de Préstamos Directos, o por los préstamos del Programa de Préstamos Perkins. Se
    cobran intereses durante un aplazamiento si se trata de préstamos sin subsidio de los programas FFEL y de Préstamos Directos.
    El Programa Federal de Préstamos para Educación de la Familia (FFEL) incluye los Préstamos Federales Stafford (con y sin subsidio), los Préstamos Federales PLUS y los
    Préstamos Federales de Consolidación.
    El Programa Federal de Préstamos Perkins (Préstamos Perkins) incluye los Préstamos Federales Perkins, los Préstamos Nacionales Directos para Estudiantes (NDSL), y
    los Préstamos para Estudiantes de Defensa Nacional (Préstamos de Defensa).
    El Programa Federal de Préstamos Directos William D. Ford (Préstamos Directos) incluye los Préstamos Federales Directos Stafford/Ford (con subsidio), los Préstamos
    Federales Directos sin Subsidio Stafford/Ford (sin subsidio), los Préstamos Federales Directos PLUS (Directos PLUS) y los Préstamos Federales Directos de Consolidación
    (Directos de consolidación).
    Indulgencia es una suspensión temporal del pago, que permite una prórroga del plazo para efectuar los pagos, o bien un permiso temporal para efectuar pagos de menor
    cuantía que lo previamente acordado. Tengo la responsabilidad de pagar los intereses que se acumulan en mis préstamos durante el periodo de indulgencia. Si no pago los
    intereses que se acumulan en un programa FFEL o de Préstamos Directos durante el periodo de indulgencia, se podría capitalizarlos. Los intereses por pagar que se
    acumulen en un préstamo del Programa de Préstamos Perkins durante el periodo de indulgencia no se capitalizan.
    El titular de un préstamo del Programa FFEL puede ser una entidad de préstamo o crédito, una agencia de garantía o el Departamento de Educación de EE.UU. El titular de
    mi(s) préstamo(s) del Programa de Préstamos Directos es el Departamento de Educación (el Departamento). El titular de mi(s) préstamos del Programa de Préstamos Perkins
    es una universidad o el Departamento.
    Por operaciones militares se entiende toda eventual operación según lo definido en 10 U.S.C. 101(a)(13). Por eventual operación se entiende una operación militar que (1)
    sea designada por el Secretario de Defensa de EE.UU. como una operación en la cual los miembros de las Fuerzas Armadas participan, o podrían llegar a participar, en
    actividades, operaciones u hostilidades militares contra un enemigo de EE.UU. o contra alguna fuerza militar opositora; o bien (2) provoque una convocatoria u orden dirigida a
    los miembros en actividad de las fuerzas armadas para que presten servicio activo según lo estipulado en 10 U.S.C. 688, 12301(a), 12302, 12304, 12305, o 12406; 10 U.S.C.
    Capítulo 15; o en cualquier otra disposición legal durante una guerra o emergencia nacional declarada por el Presidente o Congreso.
    Por emergencia nacional se entiende la emergencia que es consecuencia de los ataques terroristas declarada por el Presidente el 14 de septiembre de 2001, o las posteriores
    emergencias nacionales declaradas por el Presidente como consecuencia de ataques terroristas.
    Por servicio habilitante en la Guardia Nacional durante una guerra o alguna otra operación o emergencia nacional se entiende el adiestramientos u otro tipo de servicio,
    que no sea pasivo, prestado por un miembro de la Guardia Nacional como servicio a tiempo completo en la Guardia Nacional, según lo definido en 10 U.S.C. 101(d)(5), en virtud
    de un llamado a prestar servicio activo autorizado por el Presidente o el Secretario de Defensa. El entrenamiento u otro tipo de servicio deberá realizarse durante más de 30
    días consecutivos, según 32 U.S.C. 502(f), en relación con una guerra, alguna otra operación militar o emergencia nacional según fuera declarada por el Presidente y financiada
    con fondos federales.
    Por prestar servicio activo durante una guerra u otra operación militar o emergencia nacional se entiende todo servicio prestado por una persona que es (1) reservista de
    alguna de las Fuerzas Armadas que fuera convocado a prestar servicio activo según lo dispuesto en 10 U.S.C. 12301(a), 12301(g), 12302, 12304, ó 12306, o bien (2) algún
    retirado de las Fuerzas Armadas que haya recibido órdenes de prestar servicio activo según 10 U.S.C. 688 en relación con alguna guerra u otra operación militar o emergencia
    nacional, independientemente del lugar en el que tenga que prestar dicho servicio activo; o bien (3) cualquier otro miembro de las Fuerzas Armadas en actividad durante alguna
    emergencia o acciones o condiciones posteriores que haya sido designado a un destino de servicio que esté ubicado en algún lugar que no sea aquel donde esté normalmente
    asignado.
    Los préstamos del Título IV incluyen aquellos otorgados en virtud de los programas FFEL, Préstamos Directos y Préstamos Perkins.
SECCIÓN 7: CRITERIOS DE ELEGIBILIDAD PARA RECIBIR APLAZAMIENTO POR SERVICIO MILITAR
    El aplazamiento por servicio militar está disponible únicamente para lo siguiente:
          Préstamos Federales Stafford (con y sin subsidio), Préstamos Federales PLUS, Préstamos Directos con Subsidio, Préstamos Directos sin Subsidio, Préstamos Directos
          PLUS y Préstamos Federales Perkins, que fueran desembolsados el 1º de julio de 2001, o después de esa fecha, y
          Préstamos Federales de Consolidación y Préstamos Directos de Consolidación, únicamente si todos los préstamos del Título IV incluidos en la consolidación fueron
          desembolsados el 1º de julio de 2001 o después de esa fecha.
      Se puede aplazar el pago de los préstamos elegibles por un máximo de 3 años mientras el prestatario:
          Se encuentra prestando servicio activo durante una guerra o alguna otra operación militar o emergencia nacional. Es necesario presentar al titular del préstamo una
          copia de las órdenes militares o una declaración escrita del comandante u oficial de personal, o bien el comandante u oficial de personal tiene que certificar la Sección 4
          de este formulario; o bien
          Se encuentra prestando servicio activo habilitante para la Guardia Nacional durante una guerra o alguna otra operación militar o emergencia nacional. Es necesario
          presentar al titular del préstamo una copia de las órdenes militares o una declaración escrita del comandante u oficial de personal, o bien el comandante u oficial de
          personal tiene que certificar la Sección 4 de este formulario.




                                                                                     Pág. 2 de 3
SECCIÓN 8: DÓNDE ENVIAR LA SOLICITUD DE APLAZAMIENTO UNA VEZ COMPLETA
Envíe la solicitud completa de aplazamiento y los documentos necesarios a:
                                                                                              Si necesita ayuda para llenar este formulario, llame al:




SECCIÓN 9: AVISOS IMPORTANTES
Información de la Ley de Privacidad. La Ley de Privacidad de 1974 (5 U.S.C. 552a) exige que le proporcionemos la siguiente información:
Las autorizaciones para recolectar la información solicitada de usted y sobre usted se encuentran en las Secciones §421 et seq., §451 et seq. y/o §461 et seq. de la Ley de
Educación Superior (HEA) de 1965, según fueran modificadas (20 U.S.C. 1071 et seq., 20 U.S.C. 1087a et seq. y 20 U.S.C. 1087aa et seq.) y la autorización para recolectar y usar su
Número de Seguro Social (SSN) está en la Sección §484(a)(4) de la HEA (20 U.S.C. 1091(a)(4)) y 31 U.S.C. 7701(b). La participación en el Programa Federal de Préstamos para la
Educación de la Familia (FFEL) o en el Programa Federal de Préstamos Directos (Direct Loan) William D. Ford o el Programa Federal de Préstamos Perkins (Préstamos Perkins), así
como la divulgación de su SSN, son voluntarias, pero usted debe proporcionar la información solicitada, incluso su SSN, para participar.
El objeto principal de obtener la información que se solicita en este formulario, incluso su SSN, es verificar su identidad, determinar si reúne los requisitos para recibir un préstamo o
algún beneficio de un préstamo (como, por ejemplo, aplazamiento, indulgencia de pago, cancelación o perdón) en virtud de los Programas FFEL, Préstamos Directos (Direct Loans)
y/o Préstamos Perkins, para permitir el servicio de su(s) préstamo(s) y, en caso de ser necesario, ubicarlo y cobrar y reportar su(s) préstamo(s) si estuvieran en mora o incumplimiento
de pago. Además, usamos su SSN para identificar la cuenta y poder tener acceso electrónico a la información de la cuenta.
La información de su expediente podría ser divulgada a terceros, en forma individual o en virtud de algún programa de computación de uso común, según fuere autorizado en los usos
de rutina de los sistemas de registros correspondientes. Los usos de rutina de esta información incluyen, entre otros, su divulgación a agencias federales, estatales o locales, a
terceros o particulares tales como parientes, empleadores actuales y anteriores, colegas profesionales y personales, agencias de antecedentes crediticios del consumidor,
instituciones financieras y educativas, así como agencias de garantías, a efectos de verificar su identidad, determinar su elegibilidad para recibir un préstamo o un beneficio para el
préstamo, posibilitar la prestación de servicios o el cobro de su(s) préstamo(s), cumplimentar los términos del (de los) préstamo(s), investigar posibles fraudes y verificar su
conformidad con la reglamentación de los programas federales de ayuda económica para estudiantes, o para ubicarlo si se atrasa o deja de pagar su(s) préstamo(s). Para
proporcionar información de los cálculos del porcentaje de incumplimiento de pago, se podría dar a conocer datos a las agencias de garantía, instituciones financieras y educativas, o
a las agencias estatales. Para proporcionar información de antecedentes de asistencia financiera, se podría brindar datos a las instituciones educativas. Para asistir a los
administradores del programa con el seguimiento de los reembolsos y las cancelaciones, se podría brindar información a las agencias de garantías, instituciones financieras y
educativas, o a las agencias federales o estatales. Para brindar un método estándar para que las instituciones educativas puedan informar eficazmente el estado de matriculación de
sus alumnos, se podría brindar información a las agencias de garantías o a las instituciones financieras y educativas. Para brindarle asistencia en el pago del (de los) préstamos, se
podría proporcionar información a las agencias de garantía, instituciones financieras y educativas, o a las agencias estatales.
Si participamos en algún litigio, podríamos enviar información al Departamento de Justicia, a un tribunal, a un órgano judicial, asesor jurídico, tercero o testigo si esa información está
relacionada y es necesaria para el litigio. Si esta información, por sí misma o en combinación con otra información, indicase una posible violación de la ley, podríamos enviarla a la
autoridad correspondiente para considerar una acción judicial. Podríamos enviar información a los miembros del Congreso si usted les solicita que lo asistan con aspectos relativos a
la ayuda federal para estudiantes. En circunstancias relacionadas con reclamos, quejas o medidas disciplinarias relacionadas con empleos, podremos divulgar información
relacionada para adjudicar o investigar el asunto. Si lo dispusiera un contrato colectivo de trabajo, podríamos divulgar la información a una organización laboral reconocida en virtud
de lo dispuesto en 5 U.S.C. Capítulo 71. Se podría dar a conocer esta información a nuestros contratistas a efectos de llevar a cabo alguna función programática que exija la
divulgación de la información que obre en nuestros registros. Antes de efectuar alguna divulgación de información, exigiremos al contratista que respete las protecciones
garantizadas por la Ley de Privacidad. También podríamos divulgar información a investigadores calificados en virtud de lo dispuesto en la Ley de Privacidad.
Aviso sobre la Ley de Reducción del Papeleo. De acuerdo con la Ley de Reducción del Papeleo de 1995, ninguna persona está obligada a responder a una solicitud de
información a menos que la misma tenga un número de control de OMB que esté vigente. El número de control válido de OMB para esta solicitud de información es el 1845-0080. El
tiempo necesario para llenar esta solicitud de información se estima en un promedio de 0,5 hora (30 minutos) por respuesta, incluyendo el tiempo para leer las instrucciones, buscar
recursos de información existente, reunir y mantener los datos necesarios y llenar y revisar la solicitud de información. Si tiene algún comentario con relación a la precisión de la
estimación del tiempo o sugerencias para mejorar este formulario, escriba a:

U.S. Department of Education
Washington, DC 20202-4700

Si tiene algún comentario o inquietud en relación al estado de su presentación particular de este formulario, comuníquese con el titular de su(s) préstamo(s) (ver Sección
8).




                                                                                        Pág. 3 de 3
                      PARENTAL LEAVE / WORKING MOTHER DEFERMENT REQUEST                                                                                               .
                                                                                                                                                                      OMB No. 1845-0005
                      Federal Family Education Loan Program                                                                                                           Form Approved
                      Use this form only if you have an outstanding balance on a Federal Family Education Loan Program loan that was made before July 1, 1993, or     Exp. Date 05/31/2012
                      had a balance on a loan that was made before July 1, 1993, at the time you obtained a loan disbursed on or after July 1, 1993.
                      WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents is
                      subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.
PLWM
SECTION 1: BORROWER IDENTIFICATION
                                                                                                      Please enter or correct the following information.
                                                                                                      SSN |__|__|__|-|__|__|-|__|__|__|__|
                                                                                                      Name
                                                                                                      Address
                                                                                                      City, State, Zip Code
                                                                                                      Telephone - Home (        )
                                                                                                      Telephone - Other (       )
                                                                                                      E-mail Address (Optional)
SECTION 2: DEFERMENT REQUEST
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 5, 6, and 7.
 I meet the qualifications stated in Section 7 for the deferment checked below and request that my loan holder defer repayment of my loan(s) beginning |__|__|-|__|__|-|__|__|__|__|
   while I am (check one):
       On PARENTAL LEAVE.
       NOTE: For a Parental Leave Deferment, the beginning deferment date listed above must be within 6 months of the date you were last enrolled in school at least half time.
       Federal PLUS Loans and Federal Consolidation Loans are not eligible for Parental Leave Deferments.
       A WORKING MOTHER.
        NOTE: Federal PLUS Loans and Federal Consolidation Loans are not eligible for Working Mother Deferments.
SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
 I understand that:
   (1) I am not required to make payments of loan principal during my deferment. Interest will not be charged on my subsidized loan(s) during my deferment. However, interest will
       be charged on my unsubsidized loan(s).
   (2) I have the option of paying the interest that accrues on my unsubsidized loan(s) during my deferment.
   (3) I may choose to make interest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period.
          I wish to make interest payments on my unsubsidized loan(s) during my deferment.
   (4) My deferment will begin on the date the condition that qualifies me for the deferment began.
   (5) For the Parental Leave Deferment, the date that I was last enrolled at least half time must be certified by the authorized official who completes Section 4 of this form.
   (6) My deferment will end on the earlier of the date that the condition that establishes my deferment eligibility ends or the date on which I reach the maximum period of deferment
       under the law.
   (7) If my deferment does not cover all my past due payments, my loan holder may grant me a forbearance for all payments due before the begin date of my deferment or—if the
       period for which I am eligible for a deferment has ended—a forbearance for all payments due at the time my deferment request is processed.
   (8) If I am applying for a Parental Leave Deferment and am in my grace period, I agree to waive up to one month of my grace period so that my deferment begins within 6 months
       of the date I was last enrolled in school at least half time.
   (9) My loan holder may grant me a forbearance on my loans for up to 60 days, if necessary, for the collection and processing of documentation related to my deferment request.
       Interest that accrues during the forbearance will not be capitalized.
 I certify that: (1) The information I provided in Sections 1 and 2 above is true and correct. (2) I will provide additional documentation to my loan holder, as required, to support my
   deferment status. (3) I will notify my loan holder immediately when the condition(s) that qualified me for the deferment ends. (4) I have read, understand, and meet the eligibility
   criteria of the deferment for which I have applied, as explained in Section 7.
 I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to contact me regarding my loan(s), including repayment of my
   loan(s), at the current or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded
   voice or text messages.
Borrower’s Signature                                                                                                                                    Date

SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION
Required for Parental Leave Deferments only.
I certify, to the best of my knowledge and belief, that the borrower named above was last enrolled at least half time on: |__|__|-|__|__|-|__|__|__|__|.
Name of Institution                                                                                                                           OPE-ID

Address                                                                                                                                       City, State, Zip Code

Name/Title of Authorized Official                                                                                                             Telephone (       )

Authorized Official’s Signature                                                                                                               Date




                                                                                            Page 1 of 3
SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Report dates as month-day-year (MM-DD-YYYY). For example, ‘January 31, 2009’ = ‘01-31-2009’. If you are applying for a Parental Leave Deferment,
an authorized official must complete Section 4. If you need help completing this form, contact your loan holder.
Return the completed form and any required documentation to the address shown in Section 8.
SECTION 6: DEFINITIONS
 An authorized certifying official for the Parental Leave Deferment is an authorized official from the school where I was enrolled at least half time within the 6-month period
  preceding this deferment.
 Capitalization is the addition of unpaid interest to the principal balance of my loan. The principal balance of a loan increases when payments are postponed during periods of
  deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more
  payments may be required. The chart below provides estimates, for a $15,000 unsubsidized loan balance at a 9% interest rate, of the monthly payments due following a 12-month
  deferment. It compares the effects of paying the interest as it accrues, capitalizing the interest at the end of the deferment, and capitalizing interest quarterly and at the end of the
  deferment. My actual loan interest cost will depend on my interest rate, length of the deferment, and frequency of capitalization. Paying interest during the period of deferment
  lowers the monthly payment by about $18 and saves about $772 over the lifetime of the loan, as depicted in the chart below.
             Treatment of Interest Accrued                 Loan         Capitalized Interest    Principal to          Monthly        Number of       Total Amount       Total Interest
                     During Deferment                     Amount          for 12 Months           Be Repaid           Payment        Payments           Repaid              Paid
      Interest is paid                                   $15,000.00            $0.00             $15,000.00           $190.01           120           $24,151.64*        $9,151.64
      Interest is capitalized at the end of deferment    $15,000.00          $1,350.00           $16,350.00           $207.11           120           $24,853.79         $9,853.79
      Interest is capitalized quarterly during
                                                         $15,000.00          $1,396.25           $16,396.25           $207.70            120          $24,924.09          $9,924.09
      deferment and at the end of deferment
   *Total amount repaid includes $1,350 of interest paid during the 12-month period of deferment.
 A deferment is a period during which I am entitled to postpone repayment of the principal balance of my loan(s). The federal government pays the interest that accrues during an
  eligible deferment for all subsidized Federal Stafford Loans and for Federal Consolidation Loans for which the Consolidation Loan application was received by my loan holder (1)
  on or after January 1, 1993, but before August 10, 1993, (2) on or after August 10, 1993, if it includes only Federal Stafford Loans that were eligible for federal interest subsidy, or
  (3) on or after November 13, 1997, for that portion of the Consolidation Loan that paid a subsidized FFEL Program loan or a subsidized Federal Direct Loan. I am responsible for
  the interest that accrues during this period on all other FFEL Program loans.
 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal Supplemental Loans for Students (SLS),
  Federal PLUS Loans, and Federal Consolidation Loans.
 Forbearance means permitting the temporary cessation of payments, allowing an extension of time for making payments, or temporarily accepting smaller payments than
  previously scheduled. I am responsible for the interest that accrues on my loan(s) during a forbearance. If I do not pay the interest that accrues, the interest may be capitalized.
 Full-time employment is defined as working at least 30 hours per week in a position expected to last at least three months.
 The holder of my FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the U.S. Department of Education.
SECTION 7: ELIGIBILITY CRITERIA FOR PARENTAL LEAVE / WORKING MOTHER DEFERMENT REQUEST
 To qualify for a Parental Leave / Working Mother Deferment:
   • I must have an outstanding balance on at least one FFEL Program loan which was made before July 1, 1993, or I must have had a balance on a loan that was made before
    July 1, 1993, at the time I obtained any loan disbursed on or after July 1, 1993.
   • I am not eligible for the Parental Leave or Working Mother Deferments on my Federal PLUS Loan(s) or Federal Consolidation Loan(s).
   • I am eligible for the Working Mother Deferment only if I am a Federal Stafford or SLS loan borrower whose first FFEL Program loan was made on or after July 1, 1987 and
    before July 1, 1993.
 I may defer repayment of my loan(s) while I am:
   • On PARENTAL LEAVE. (Maximum eligibility is 6 months per occurrence.) To qualify:
      (1) I must:
           (a) be pregnant, caring for my newborn child (a child less than 6 months of age), or caring for my newly adopted child;
           (b) not be working full time or attending school during the deferment period; and
           (c) have been enrolled in school at least half time within the 6-month period preceding this deferment (an authorized school must certify my enrollment in Section 4).
      (2) I must provide my loan holder with:
           (a) a statement from my physician documenting my pregnancy, if I am requesting this deferment due to my pregnancy; or
           (b) a copy of my newborn child’s birth certificate; or
           (c) a statement from the adoption agency documenting my newly adopted child’s placement and the placement date.
   • A WORKING MOTHER. (Maximum eligibility is 12 months.) To qualify:
      (1) I must:
           (a) have entered or reentered the workforce within one year preceding this deferment;
           (b) be working full time in a position earning not more than $1 per hour above the federal minimum wage; and
           (c) be the mother of a preschool-age child who has not yet enrolled in the first grade or a higher grade in elementary school.
      (2) I must provide my loan holder with documentation of:
           (a) my rate of pay, such as a pay stub; and
           (b) the age of my preschool-age child, such as a birth certificate.




                                                                                      Page 2 of 3
SECTION 8: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST
Return the completed deferment request and any required documentation to:                         If you need help completing this form, call:
(If no address is shown, return to your loan holder.)                                             (If no telephone number is shown, call your loan holder.)




SECTION 9: IMPORTANT NOTICES
Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §421 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and the
authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family
Education Loan Program (FFELP) and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
(such as a deferment, forbearance, discharge, or forgiveness) under the FFELP, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and
report on your loan(s) if your loan(s) becomes delinquent or in default. We also use your SSN as an account identifier and to permit you to access your account information
electronically.
The information in your file may be disclosed, on a case-by-case basis or under a computer matching program, to third parties as authorized under routine uses in the appropriate
systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local agencies, to private parties such as relatives,
present and former employers, business and personal associates, to consumer reporting agencies, to financial and educational institutions, and to guaranty agencies in order to verify
your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s), to investigate
possible fraud and to verify compliance with federal student financial aid program regulations, or to locate you if you become delinquent in your loan payments or if you default. To
provide default rate calculations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history
information, disclosures may be made to educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal or state agencies. To provide a standardized method for educational institutions to efficiently submit student enrollment
status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in repayment efforts, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to the
litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate authority for action. We may send
information to members of Congress if you ask them to help you with federal student aid questions. In circumstances involving employment complaints, grievances, or disciplinary
actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective bargaining agreement, we may disclose records to a labor organization
recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for the purpose of performing any programmatic function that requires disclosure of records.
Before making any such disclosure, we will require the contractor to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act
safeguards.
Paperwork Reduction Notice
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The
valid OMB control number for this information collection is 1845-0005. The time required to complete this information collection is estimated to average 0.16 hours (10 minutes) per
response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and complete and review the information collection. If you
have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, DC 20202-4537
If you have questions regarding the status of your individual submission of this form, write directly to the address shown in Section 8.




                                                                                        Page 3 of 3
                                                                                                                                                                  .
                   SOLICITUD DE APLAZAMIENTO DE PAGO: PERMISO POR                                                                                                     N.o de OMB: 1845-0005
                   MATERNIDAD O PATERNIDAD / MADRES QUE TRABAJAN                                                                                                      Formulario aprobado
                                                                                                                                                                      Caduca: 31 mayo 2012
                   Federal Family Education Loan ProgramSM
                   Sólo utilice el presente formulario si tiene un saldo pendiente de pago en algún préstamo hecho mediante el programa de préstamos educativos
                   Federal Family Education Loan Program (FFELSM) antes del 1 de julio de 1993, o si tenía, en el momento de obtener un préstamo que se
 PLWM              desembolsó el 1 de julio de 1993 o posterior, un saldo pendiente de pago en algún préstamo hecho antes del 1 de julio de 1993.
                   AVISO: El que a sabiendas haga declaraciones falsas o engañosas en el presente formulario, o en cualquier documento adjunto al mismo,
                   quedará sujeto a sanciones, las cuales pueden incluir las multas, el encarcelamiento o ambas penas, de conformidad con el Código Penal de
                   EE.UU. y con la Sección 1097 del Título 20 del Código de Estados Unidos.

SECCIÓN 1: DATOS PERSONALES DEL PRESTATARIO
                                                                                                   Favor de introducir o corregir la siguiente información:
                                                                                                   N.o de Seguro Social
                                                                                                   Nombre y apellido
                                                                                                   Dirección
                                                                                                   Ciudad, estado, código postal
                                                                                                   Teléfono (domicilio) (        )
                                                                                                   Teléfono (alternativo) (      )
                                                                                                   Correo electrónico (opcional)

SECCIÓN 2: SOLICITUD DE APLAZAMIENTO DE PAGO
Antes de responder a las preguntas, lea todo el formulario detenidamente, incluyendo las indicaciones y otra información que se hallan en las Secciones 5, 6 y 7.
  Cumplo con los requisitos, estipulados en la Sección 7, para acogerme al aplazamiento de pago por el motivo indicado abajo, y solicito que mi acreedor aplace el pago de mis
  préstamos a partir del                                       y mientras (marque una de las casillas siguientes):
       Tengo PERMISO POR MATERNIDAD O PATERNIDAD.
      NOTA: A efectos del aplazamiento de pago por razones de tener permiso por maternidad o paternidad, no deberán haber transcurrido más de seis meses entre la última fecha
      en que el solicitante estuvo matriculado para estudiar con una dedicación mínima de medio tiempo y la fecha de inicio del aplazamiento indicada arriba. Los que hayan
      obtenido Préstamos Federales PLUS o Préstamos Federales de Consolidación no pueden acogerse al aplazamiento de pago basándose en un permiso por maternidad o
      paternidad.
       Soy MADRE QUE TRABAJA.
       NOTA: Las que hayan obtenido Préstamos Federales PLUS o Préstamos Federales de Consolidación no pueden acogerse al aplazamiento de pago por razones de ser madre
       que trabaja.
SECCIÓN 3: ACEPTACIÓN, CERTIFICACIÓN Y AUTORIZACIÓN DEL PRESTATARIO
  Entiendo y acepto lo siguiente:
  (1) No tengo obligación de efectuar pagos al capital del préstamo durante la vigencia del aplazamiento de pago. Durante este período, no se me cobrarán los intereses producidos
       por mis préstamos que tengan subsidio del interés. Sin embargo, se me cobrarán los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (2) Tengo la opción de pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (3) Puedo optar por pagar el interés, marcando la casilla de abajo. Mi acreedor podrá capitalizar los intereses que no se paguen durante el período de aplazamiento.
            Deseo pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (4) El aplazamiento de pago entrará en vigor en la fecha de inicio de la condición que justificó el otorgamiento de tal beneficio.
  (5) Para efectos de mi solicitud de aplazamiento de pago por razones de tener permiso por maternidad o paternidad, el funcionario o empleado autorizado que llene la Sección 4 del
       presente formulario deberá certificar la última fecha en que estuve matriculado para estudiar con una dedicación mínima de medio tiempo.
  (6) El aplazamiento de pago vencerá en la primera de las dos fechas siguientes: la fecha en que termine la condición que justificó el otorgamiento de tal beneficio o la fecha en que
       se agote el período máximo de aplazamiento permitido por ley.
  (7) Si el aplazamiento de pago no abarca todas las cuotas atrasadas, mi acreedor puede concederme un período de indulgencia de morosidad que abarque las que hayan vencido
       antes de la fecha de entrada en vigor del aplazamiento. En caso de que haya terminado el período de vigencia del aplazamiento, mi acreedor puede otorgarme un período de
       indulgencia que abarque toda cuota que haya vencido hasta la fecha de tramitación de la presente solicitud.
  (8) Si, al solicitar el aplazamiento de pago por razones de tener permiso por maternidad o paternidad, mis préstamos gozan de un período de gracia, acepto renunciar hasta un
       máximo de un mes de este período, a fin de que el aplazamiento entre en vigor dentro de los seis meses posteriores a la última fecha en que estuve matriculado para estudiar
       con una dedicación mínima de medio tiempo.
  (9) Mi acreedor puede concederme, según sea necesario, un período de indulgencia de morosidad por una duración máxima de 60 días, por motivo de la recopilación y tramitación
       de los documentos relativos a mi solicitud de aplazamiento de pago. No se capitalizarán los intereses producidos durante el plazo de vigencia de este tipo de indulgencia.
   Certifico lo siguiente: (1) que la información que proporcioné en las Secciones 1 y 2, arriba, es correcta y verídica; (2) que aportaré documentación complementaria a mi
   acreedor, según sea necesario, que acredite las circunstancias en cuya virtud me acojo al aplazamiento de pago; (3) que avisaré a mi acreedor, de forma inmediata, una vez que
   hayan terminado las condiciones que justificaron el aplazamiento de pago, y (4) que he leído, entendido y cumplido los requisitos y condiciones cuya satisfacción es necesaria para
   la concesión del aplazamiento de pago por los motivos señalados en el presente formulario de solicitud, según lo expuesto en la Sección 7.
   Autorizo a la institución educativa, al acreedor, al garante, al Departamento y a sus respectivos agentes y contratistas a comunicarse conmigo respecto a mis préstamos, incluido el
   pago de los mismos, al número actual o futuro (si lo proporciono) de mi teléfono móvil u otro dispositivo inalámbrico, por medio de sistemas de marcado automático, mensajes de
   texto o mensajes de voz artificial o grabados.

Firma del prestatario                                                                                                                                   Fecha




                                                                                        Página 1 de 4
SECCIÓN 4: CERTIFICACIÓN DEL FUNCIONARIO O EMPLEADO AUTORIZADO
La certificación siguiente es obligatoria sólo para los que soliciten el aplazamiento de pago por razones de tener permiso por maternidad o paternidad.
Certifico que, según mi leal saber y entender, la última fecha en que el prestatario arriba indicado estuvo matriculado para estudiar con una dedicación mínima de medio tiempo
fue el:                                      .

Nombre de la institución                                                                                                OPE-ID

Dirección                                                                                                               Ciudad, estado, código postal
Nombre, apellido y puesto del
funcionario o empleado autorizado                                                                                       Teléfono (     )
Firma del funcionario o
empleado autorizado                                                                                                     Fecha

SECCIÓN 5: INSTRUCCIONES PARA LLENAR EL FORMULARIO
Escriba sus respuestas a máquina o con letra de molde y tinta oscura. Escriba las fechas en el formato mes-día-año (MM-DD-AAAA). Por ejemplo, «31 de enero de 2009»
equivale a «01-31-2009». Si solicita el aplazamiento de pago por razones de tener permiso por maternidad o paternidad, un funcionario o empleado autorizado deberá rellenar la
Sección 4. Si usted necesita ayuda para llenar el presente formulario, comuníquese con su acreedor.
Remita el formulario con los datos completos, y cualquier documentación solicitada, a la dirección indicada en la Sección 8.
SECCIÓN 6: DEFINICIONES
   El acreedor de mis préstamos del Programa FFEL puede ser una entidad prestamista, garante o financiera (del mercado secundario), o el Departamento de Educación de
   EE.UU.
   El aplazamiento de pago consiste en un período durante el cual tengo derecho a posponer el pago del capital de mis préstamos. El Departamento de Educación de EE.UU.
   sufraga los intereses producidos durante el aplazamiento de pago debidamente tramitado, todo Préstamo Federal Stafford con subsidio del interés y todo Préstamo Federal
   de Consolidación cuya solicitud llegó a mi acreedor (1) el 1 de enero de 1993 o posterior pero antes del 10 de agosto de 1993, (2) el 10 de agosto de 1993 o posterior,
   siempre que la solicitud incluyera sólo los Préstamos Federales Stafford que gozaban del subsidio federal del interés, o (3) el 13 de noviembre de 1997 o posterior, cuando
   se trate de la porción del préstamo de consolidación con la que se liquidó un préstamo educativo con subsidio del interés obtenido del Programa FFEL o del Direct Loan
   ProgramSM. Tengo la responsabilidad de pagar los intereses producidos durante este período por cualquier otro préstamo hecho al amparo del Programa FFEL.
   La capitalización consiste en añadir los intereses pendientes de pago al saldo de capital del préstamo. El saldo de capital del préstamo aumenta cuando se postergan los
   pagos, durante los períodos de aplazamiento de pago o de indulgencia de morosidad, y se capitalizan los intereses. Como resultado de esto, puede que se produzcan más
   intereses durante la vigencia del préstamo, que se aumente la cantidad de la cuota mensual o que se incremente el número de los pagos. En el cuadro siguiente, se
   presentan cálculos aproximados de las cuotas mensuales de un préstamo sin subsidio del interés, hecho por un monto de $15,000 y con una tasa de 9 por ciento, después de
   un período de aplaza-miento de pago de 12 meses de duración. Se comparan los efectos de las diferentes maneras de tratar los intereses del préstamo: pagarlos a medida
   que se van produciendo, capitalizarlos al final del período de aplazamiento de pago y capitalizarlos trimestralmente y al final del período de aplazamiento de pago. El costo
   efectivo de los intereses de mi préstamo dependerá de la tasa de interés, de la duración del aplazamiento de pago y de la frecuencia de capitalización de los intereses. Como
   se puede apreciar en el cuadro, si los intereses se van pagando durante el período del aplazamiento de pago, la cuota mensual se rebaja en unos $18 y se ahorran casi $772
   durante la vigencia del préstamo.
       Tratamiento de los intereses producidos         Cantidad del       Intereses capitalizados       Capital a       Cuota         Número                       Total pagado
                                                                                                                                                  Total pagado
             durante el aplazamiento de pago            préstamo                (12 meses)               pagar         mensual       de cuotas                     en intereses
      Pagar los intereses durante
                                                        $15,000.00                 $0.00               $15,000.00       $190.01            120     $24,151.64*       $9,151.64
      el aplazamiento de pago
      Capitalizar los intereses al final
                                                        $15,000.00               $1,350.00             $16,350.00       $207.11            120     $24,853.79        $9,853.79
      del aplazamiento de pago
      Capitalizar los intereses cada
       trimestre durante el aplazamiento                $15,000.00               $1,396.25             $16,396.25       $207.70            120     $24,924.09        $9,924.09
      de pago y al final del mismo
     * El total pagado incluye los $1,350 de intereses pagados durante los 12 meses del aplazamiento de pago.
   Empleo a tiempo completo se define como el trabajar por lo menos 30 horas semanales en una plaza que se prevé que dure como mínimo tres meses.
   El Federal Family Education Loan Program (Programa FFEL) incluye los Préstamos Federales Stafford (con y sin subsidio del interés), los Préstamos Federales
   Suplementarios para Estudiantes (SLS), los Préstamos Federales PLUS y los Préstamos Federales de Consolidación.
   El funcionario o empleado autorizado para certificar los datos consignados, para efectos de la solicitud de aplazamiento de pago por razones de tener permiso por
   maternidad o paternidad, consiste en un funcionario o empleado autorizado de la institución educativa en la que estuve matriculado para estudiar con una dedicación mínima
   de medio tiempo durante los seis meses anteriores a la entrada en vigor del aplazamiento de pago.
   Indulgencia de morosidad se refiere a la suspensión temporal de las cuotas del préstamo, a la prolongación del plazo de vencimiento de las cuotas o a la reducción
   temporal de la cantidad programada de las cuotas. Tengo la responsabilidad de pagar los intereses producidos por mis préstamos durante el período de indulgencia de
   morosidad. Si no pago los intereses, éstos pueden capitalizarse.




                                                                               Página 2 de 4
SECCIÓN 7: REQUISITOS PARA ACOGERSE AL APLAZAMIENTO DE PAGO POR MOTIVOS DE TENER PERMISO POR MATERNIDAD O
          PATERNIDAD O DE SER MADRE QUE TRABAJA
 Para poder acogerme al aplazamiento de pago por estos motivos, debo cumplir con lo siguiente:
 • Debo tener un saldo pendiente de pago en algún préstamo hecho mediante el programa de préstamos educativos Federal Family Education Loan Program (Programa
   FFEL) antes del 1 de julio de 1993, o haber tenido, en el momento de obtener un préstamo que se desembolsó el 1 de julio de 1993 o posterior, un saldo pendiente en
   algún préstamo hecho antes del 1 de julio de 1993.
  • No puedo acogerme al aplazamiento de pago de mis Préstamos Federales PLUS o Préstamos Federales de Consolidación por razones de tener permiso por maternidad o
    paternidad, o de ser madre que trabaja.
  • Puedo acogerme al aplazamiento de pago por razones de ser madre que trabaja, siempre que haya obtenido Préstamos Federales Stafford o Préstamos SLS y que se
    haya hecho el primero de mis préstamos del Programa FFEL el 1 de julio de 1987 o posterior y antes del 1 de julio de 1993.
 Puedo acogerme al aplazamiento del pago de mis préstamos mientras:
  • Tengo PERMISO POR MATERNIDAD O PATERNIDAD. (Maximum eligibility is 6 months per occurrence.) Para poder acogerme al aplazamiento de pago por este
    motivo, debe cumplirse lo siguiente:
    (1) Debo:
         (a) estar embarazada o tener a mi cuidado a mi hijo o hija recién nacido (es decir, con menos de seis meses de edad) o recién adoptado;
         (b) abstenerme de trabajar a tiempo completo y de estudiar durante el período del aplazamiento de pago, y
         (c) haber estado matriculado para estudiar, con una dedicación mínima de medio tiempo, en algún momento durante los últimos seis meses anteriores al
              aplazamiento de pago (un funcionario o empleado autorizado deberá certificar, en la Sección 4, la última fecha de estar yo matriculado y mi dedicación de
              estudio).
    (2) Debo aportar a mi acreedor cualquiera de los documentos siguientes:
         (a) constancia, emitida por mi médico, de mi embarazo, en caso de solicitar el aplazamiento de pago a base del mismo;
         (b) copia de la partida de nacimiento de mi hijo o hija recién nacido o
         (c) constancia, emitida por el servicio de adopciones correspondiente, de la colocación en mi familia de mi hijo o hija adoptivo y la fecha de la misma.
  • Soy MADRE QUE TRABAJA. (El período máximo de aplazamiento es de 12 meses.) Para poder acogerme al aplazamiento de pago por este motivo, debe cumplirse lo
    siguiente:
    (1) Debo:
         (a) trabajar actualmente o haber vuelto a trabajar durante los últimos 12 meses anteriores al aplazamiento de pago que solicito por medio del presente formulario,
         (b) trabajar a tiempo completo en un puesto cuyo salario no supere en más de un dólar por hora al salario mínimo federal y
         (c) ser madre de un niño de edad preescolar que todavía no cursa el primer grado o superior en una escuela de enseñanza primaria.
    (2) Debo aportar a mi acreedor la siguiente documentación:
         (a) constancia de mi salario (p. ej., talón de pago) y
         (b) constancia de la edad de mi hijo o hija preescolar (p. ej., partida de nacimiento).




                                                                                   Página 3 de 4
 SECCIÓN 8: DÓNDE ENVIAR EL FORMULARIO CON LOS DATOS COMPLETOS
Envíe el formulario con los datos completos, y cualquier otra documentación necesaria, a     Si necesita ayuda para llenar el formulario, llame al siguiente número:
la siguiente dirección:                                                                      (De no indicarse ningún número de teléfono, llame a su acreedor.)
(De no indicarse ninguna dirección, remita el formulario a su acreedor.)




 SECCIÓN 9: AVISOS IMPORTANTES
 Aviso sobre la Ley de Confidencialidad de Información
 En virtud de la Ley de Confidencialidad de Información de 1974 (Sección 552a del Título 5 del Código de Estados Unidos), es obligatorio poner a disposición del solicitante el
 siguiente aviso:
 La autoridad para reunir la información solicitada por medio del presente formulario deriva de la Sección 421 y siguientes de la Ley de Educación Superior de 1965, según
 enmendada (Sección 1071 y siguientes del Título 20 del Código de Estados Unidos). La autoridad para solicitar y utilizar el número de Seguro Social del solicitante deriva de la
 Sección 484(a)(4) de la Ley de Educación Superior (Sección 1091[a][4] del Título 20 del Código de Estados Unidos) y de la Sección 7701(b) del Título 30 del Código de Estados
 Unidos. Si bien tienen carácter voluntario tanto la participación en el Federal Family Education Loan Program (Programa FFEL) como el proporcionar el número de Seguro
 Social, el solicitante deberá facilitar la información solicitada, incluido el número de Seguro Social, para poder participar en el Programa.
 La reunión de la información solicitada en el presente formulario (incluido el número de Seguro Social) se realiza con los siguientes fines principales: verificar la identidad del
 solicitante; determinar el otorgamiento, al amparo del Programa FFEL, de préstamos nuevos o de beneficios en materia del pago de préstamos existentes (como por ejemplo, el
 aplazamiento de pago, la indulgencia de morosidad, y la anulación o condonación de deudas); administrar los préstamos del solicitante, y, en caso de mora o incumplimiento de
 pago, localizarlo, exigirle el pago de la deuda e informar a las entidades competentes la condición de los préstamos. También hacemos uso del número de Seguro Social como
 identificador de la cuenta de préstamos del solicitante y para permitir a éste acceder electrónicamente a los datos relativos a la misma.
 Al amparo de una cláusula, debidamente publicada en el sistema de registro de datos correspondiente, relativa al uso normal de la información recogida, los datos que se
 encuentran en el expediente del solicitante se pueden poner a disposición de terceras entidades, ya sea según las circunstancias particulares del caso o en cumplimiento de un
 programa de cotejo electrónico de datos. Tratándose del presente formulario, el uso normal de esta información incluye, sin carácter limitativo, la cesión de los datos a ciertas
 partes, señaladas abajo, a fin de hacer lo siguiente: verificar la identidad del solicitante; determinar el otorgamiento de préstamos nuevos o de beneficios en materia del pago de
 préstamos existentes; permitir la administración o cobro de los préstamos; hacer cumplir los términos y condiciones de los préstamos; investigar la posible comisión de fraude y
 verificar el cumplimiento de las normas que rigen los programas federales de ayuda económica para los estudios superiores o localizar al solicitante en caso de mora o
 incumplimiento de pago. Las siguientes son las partes a las que podemos destinar la información reunida: organismos federales, estatales y locales; particulares que tienen
 alguna relación con el solicitante, tales como familiares, empleadores actuales y pasados, socios comerciales y personales; agencias de informes crediticios; instituciones
 educativas y financieras, y garantes. Para informar sobre los cálculos del índice de incumplimiento de pago, podemos ceder los datos a garantes, a instituciones financieras y
 educativas, o a organismos estatales. Para facilitar el historial de ayuda económica del solicitante, podemos ceder los datos a instituciones educativas. Para ayudar a los
 administradores del programa a llevar un control sobre la devolución de fondos de préstamo y la anulación de préstamos, podemos ceder los datos a garantes, a instituciones
 financieras y educativas, o a organismos federales o estatales. Para establecer un método estandarizado según el cual instituciones educativas puedan informar de forma
 eficiente sobre la dedicación de estudio del solicitante, podemos ceder los datos a garantes o a instituciones financieras y educativas. Para dar orientación al solicitante en
 materia del pago de préstamos, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos federales, estatales o locales.
 En caso de litigio, podemos enviar los datos del solicitante al Departamento de Justicia, o al tribunal, entidad jurídica, abogado, parte o testigo correspondientes, cuando dicha
 cesión se considere procedente y necesaria para la solución del mismo. Si estos datos, ya sean por separado o en conjunto con otra información, indican una posible violación
 de la ley, podemos enviarlos a las autoridades competentes, para que se tomen las medidas pertinentes. Podemos enviar la información a congresistas en caso que usted les
 pida ayuda con algún problema relacionado con los programas federales de asistencia estudiantil. En caso de denuncias, quejas o medidas disciplinarias en materia de empleo,
 podemos ceder los datos a las entidades competentes, a fin de facilitar la adjudicación o investigación de las mismas. Si así se dispone en una convención colectiva de trabajo,
 podemos ceder los datos a los sindicatos debidamente reconocidos al amparo del Capítulo 71 del Título 5 del Código de Estados Unidos. Podemos poner los datos a disposición
 de nuestros contratistas si los necesitan para realizar funciones relacionadas con los programas en referencia. Antes de hacerlo, requerimos que el contratista ponga en práctica
 las medidas de protección necesarias para cumplir con la Ley de Confidencialidad de Información. Los datos también pueden cederse, de conformidad con las protecciones
 previstas en la Ley de Confidencialidad de Información, a aquellos investigadores que reúnan los requisitos correspondientes.
 Aviso sobre la Ley de Reducción de Trámites
 Según lo dispuesto en la Ley de Reducción de Trámites de 1995, ninguna persona estará en la obligación de responder a un instrumento de recolección de datos que no exhiba
 un número de control vigente emitido por la Oficina de Administración y Presupuesto (OMB, por sus siglas en inglés). Para efectos del presente formulario, dicho número es
 1845-0005. Se calcula que se necesitan, como promedio, 0.16 horas (10 minutos) por respuesta, incluido el tiempo para leer las instrucciones, buscar la información en los
 documentos correspondientes, reunir los datos necesarios, consignarlos en el formulario y revisarlos. Si usted tiene algún comentario sobre la exactitud de estos cálculos,
 o alguna sugerencia sobre cómo mejorar el presente formulario, escriba a la siguiente dirección:
 U.S. Department of Education, Washington, DC 20202-4537
 Si tiene preguntas sobre el estado de tramitación de su formulario, escriba a la dirección indicada en la Sección 8.




                                                                                  Página 4 de 4
                     PARENT PLUS BORROWER DEFERMENT REQUEST                                                                                                          OMB No. 1845-0005
                     Federal Family Education Loan Program                                                                                                           Form Approved
                     Use this form if you are a parent borrower with a Federal PLUS Loan that was first disbursed on or after July 1, 2008, or if you have an        Exp. Date 05/31/2012
                     outstanding balance on a Federal Family Education Loan Program loan that was made before July 1, 1993, or had a balance on a loan that
                     was made before July 1, 1993, at the time you obtained a loan disbursed on or after July 1, 1993.
   PLUS              WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents is
                     subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.
SECTION 1: BORROWER IDENTIFICATION
                                                                                                      Please enter or correct the following information.
                                                                                                      SSN |__|__|__|-|__|__|-|__|__|__|__|
                                                                                                      Name
                                                                                                      Address
                                                                                                      City, State, Zip Code
                                                                                                      Telephone - Home (        )
                                                                                                      Telephone - Other (       )
                                                                                                      E-mail Address (Optional)
SECTION 2: DEFERMENT REQUEST
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 5, 6, and 7.
 I meet the qualifications stated in Section 7 for this deferment and request that my loan holder defer repayment of my loan(s) while the student (named below) for whom I borrowed
  a PLUS loan is (check one):
       Enrolled at least half time at an eligible school.
       Engaged full time in a rehabilitation training program.
 By checking the box below, I may also request a deferment on my parent Federal PLUS Loan(s) that was first disbursed on or after July 1, 2008 during the 6-month period after
  the student (named below) for whom I borrowed the loan ceases to be enrolled at least half time at an eligible school.
       I request that my loan holder defer repayment of my Federal PLUS Loan(s) that was first disbursed on or after July 1, 2008 during the 6-month period after the student named
        below ceases to be enrolled at least half time at an eligible school.
Student’s Name                                                                                                                      Student’s SSN           |__|__|__|-|__|__|-|__|__|__|__|

SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
 I understand that:
   (1) I am not required to make payments of loan principal during my deferment. However, interest will be charged on my loan(s).
  (2) I have the option of paying the interest that accrues on my unsubsidized loan(s) during my deferment.
  (3) I may choose to make interest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period.
            I wish to make interest payments on my unsubsidized loan(s) during my deferment.
  (4) My deferment based on the student’s enrollment at an eligible school or participation in a rehabilitation program will begin on the date the condition that qualifies me for the
      deferment began, as certified by the authorized official who completes Section 4 of this form, and will end on the earlier of the date that the student no longer meets the
      condition that qualifies me for the deferment, or the ending date of that condition as certified by the authorized official.
  (5) If I request a deferment during the 6-month period after the student’s half-time enrollment, the deferment will begin the day after the student ceases to be enrolled on at least a
      half-time basis and will end 6 months after that date.
  (6) If my deferment does not cover all my past due payments, my loan holder may grant me a forbearance for all payments due before the begin date of my deferment or—if the
      period for which I am eligible for a deferment has ended—a forbearance for all payments due at the time my deferment request is processed.
  (7) My loan holder may grant me a forbearance on my loans for up to 60 days, if necessary, for the collection and processing of documentation related to my deferment request.
      Interest that accrues during the forbearance will not be capitalized.
   I certify that: (1) The information I provided in Sections 1 and 2 above is true and correct. (2) I will provide additional documentation to my loan holder, as required, to support
      my deferment status. (3) I will notify my loan holder immediately when the condition(s) that qualified me for the deferment ends. (4) I have read, understand, and meet the
      eligibility criteria of the deferment for which I have applied, as explained in Section 7.
   I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to contact me regarding my loan(s), including repayment of my
      loan(s), at the current or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or
      prerecorded voice or text messages.

Borrower’s Signature                                                                                                                              Date

SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION
I certify, to the best of my knowledge and belief, that the student named above is/was enrolled at an eligible institution or engaged in the program indicated in Section 2, and that the
student and (if applicable) the student’s program meet all the eligibility requirements specified in Section 7 on the following page.
          Is/was enrolled as an at least half-time student
           during the academic period from |__|__|-|__|__|-|__|__|__|__| to |__|__|-|__|__|-|__|__|__|__| and is reasonably expected to complete his/her program
           requirements on |__|__|-|__|__|-|__|__|__|__|.
        Is/was engaged full time in a rehabilitation training program that began on |__|__|-|__|__|-|__|__|__|__| and will end/ended on |__|__|-|__|__|-|__|__|__|__|.

Name of Institution/Facility                                                                                      OPE-ID (if applicable)
Address                                                                                                           City, State, Zip Code
Name/Title of Authorized Official                                                                                 Telephone (        )
Authorized Official’s Signature                                                                                   Date




                                                                                            Page 1 of 3
SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Report dates as month-day-year (MM-DD-YYYY). For example, ‘January 31, 2009’ = ‘01-31-2009’. An authorized school/program official must complete
Section 4. If you need help completing this form, contact your loan holder.
Return the completed form and any required documentation to the address shown in Section 8.
SECTION 6: DEFINITIONS
 Authorized certifying officials:
   • Authorized School Official (for students enrolled full time or at least half time at an eligible institution)
   • Authorized Rehabilitation Training Program Official
 Capitalization is the addition of unpaid interest to the principal balance of my loan. The principal balance of a loan increases when payments are postponed during periods of
  deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more
  payments may be required. The chart below provides estimates, for a $15,000 unsubsidized loan balance at a 9% interest rate, of the monthly payments due following a 12-month
  deferment. It compares the effects of paying the interest as it accrues, capitalizing the interest at the end of the deferment, and capitalizing interest quarterly and at the end of the
  deferment. My actual loan interest cost will depend on my interest rate, length of the deferment, and frequency of capitalization. Paying interest during the period of deferment
  lowers the monthly payment by about $18 and saves about $772 over the lifetime of the loan, as depicted in the chart below.
             Treatment of Interest Accrued                 Loan         Capitalized Interest    Principal to              Monthly       Number of       Total Amount    Total Interest
                     During Deferment                     Amount          for 12 Months           Be Repaid               Payment       Payments           Repaid           Paid
      Interest is paid                                   $15,000.00            $0.00             $15,000.00               $190.01          120           $24,151.64*     $9,151.64
      Interest is capitalized at the end of deferment    $15,000.00          $1,350.00           $16,350.00               $207.11          120           $24,853.79      $9,853.79
      Interest is capitalized quarterly during
                                                         $15,000.00          $1,396.25           $16,396.25               $207.70           120           $24,924.09      $9,924.09
      deferment and at the end of deferment
   *Total amount repaid includes $1,350 of interest paid during the 12-month period of deferment.
 A deferment is a period during which I am entitled to postpone repayment of the principal balance of my loan(s). The federal government pays the interest that accrues during an
  eligible deferment for all subsidized Federal Stafford Loans and for Federal Consolidation Loans for which the Consolidation Loan application was received by my loan holder (1)
  on or after January 1, 1993, but before August 10, 1993, (2) on or after August 10, 1993 if it includes only Federal Stafford Loans that were eligible for federal interest subsidy, or
  (3) on or after November 13, 1997, for that portion of the Consolidation Loan that paid a subsidized FFEL Program loan or a subsidized Federal Direct Loan. I am responsible for
  the interest that accrues during this period on all other FFEL Program loans.
 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal Supplemental Loans for Students (SLS),
  Federal PLUS Loans, and Federal Consolidation Loans.
 Forbearance means permitting the temporary cessation of payments, allowing an extension of time for making payments, or temporarily accepting smaller payments than
  previously scheduled. I am responsible for paying the interest that accrues on my loan(s) during a forbearance. If I do not pay the interest that accrues, the interest may be
  capitalized.
 The holder of my FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the U.S. Department of Education.
SECTION 7: ELIGIBILITY CRITERIA FOR PARENT PLUS BORROWER DEFERMENT REQUEST
To qualify:
 If I have an outstanding Federal PLUS Loan which was first disbursed on or after July 1, 2008, I may defer repayment while the student for whom I obtained the loan is enrolled at
   least half time at an eligible school.
 I may also defer repayment of my parent Federal PLUS Loan(s) that was first disbursed on or after July 1, 2008 during the 6-month period after the student ceases to be enrolled
   at an eligible school on at least a half-time basis.
 If I have an outstanding balance on a FFEL Program loan which was made on or after July 1, 1987, and before July 1, 1993, or I had an outstanding balance on a FFEL Program
   loan made before July 1, 1993, when I obtained a loan disbursed on or after July 1, 1993, I may defer repayment of my loan(s) while the student for whom I borrowed a Federal
   PLUS Loan is dependent and is:
   •     Enrolled at least half time at an eligible school.
   •     Engaged full time in a rehabilitation training program. To qualify: (1) The training program must (a) be licensed, approved, certified or recognized as providing rehabilitation
         training to disabled individuals by the Department of Veterans Affairs or a state agency responsible for vocational rehabilitation, drug abuse treatment, mental health
         services, or alcohol abuse treatment programs; (b) provide services under a written individualized plan that specifies the date the services are expected to end; and (c) be
         structured in a way that requires a substantial commitment by the student to his/her rehabilitation. (“Substantial commitment” means a commitment of time and effort that
         would normally prevent a person from being employed 30 or more hours per week in a position expected to last at least 3 months.) (2) The dependent student must be
         either receiving, or scheduled to receive, these rehabilitation services.
SECTION 8: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST
Return the completed deferment request and any required documentation to:                           If you need help completing this form, call:
(If no address is shown, return to your loan holder.)                                               (If no telephone number is shown, call your loan holder.)




                                                                                          Page 2 of 3
SECTION 9: IMPORTANT NOTICES
Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §421 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and the
authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family
Education Loan Program (FFELP) and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
(such as a deferment, forbearance, discharge, or forgiveness) under the FFELP, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and
report on your loan(s) if your loan(s) becomes delinquent or in default. We also use your SSN as an account identifier and to permit you to access your account information
electronically.
The information in your file may be disclosed, on a case-by-case basis or under a computer matching program, to third parties as authorized under routine uses in the appropriate
systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local agencies, to private parties such as relatives,
present and former employers, business and personal associates, to consumer reporting agencies, to financial and educational institutions, and to guaranty agencies in order to verify
your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s), to investigate
possible fraud and to verify compliance with federal student financial aid program regulations, or to locate you if you become delinquent in your loan payments or if you default. To
provide default rate calculations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history
information, disclosures may be made to educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal or state agencies. To provide a standardized method for educational institutions to efficiently submit student enrollment
status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in repayment efforts, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to the
litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate authority for action. We may send
information to members of Congress if you ask them to help you with federal student aid questions. In circumstances involving employment complaints, grievances, or disciplinary
actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective bargaining agreement, we may disclose records to a labor organization
recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for the purpose of performing any programmatic function that requires disclosure of records.
Before making any such disclosure, we will require the contractor to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act
safeguards.
Paperwork Reduction Notice
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The
valid OMB control number for this information collection is 1845-0005. The time required to complete this information collection is estimated to average 0.16 hours (10 minutes) per
response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and complete and review the information collection. If you
have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, DC 20202-4537
If you have questions regarding the status of your individual submission of this form, write directly to the address shown in Section 8.




                                                                                        Page 3 of 3
                   SOLICITUD DE APLAZAMIENTO DE PAGO:                                                                                                               N.o de OMB: 1845-0005

                   PADRES CON PRÉSTAMOS PLUS                                                                                                                        Formulario aprobado
                                                                                                                                                                    Caduca: 31 mayo 2012
                   Federal Family Education Loan ProgramSM
                   Sólo utilice el presente formulario (1) si usted obtuvo, mediante el programa de préstamos educativos Federal Family Education Loan Program
                   (FFELSM), un Préstamo PLUS que se desembolsó por primera vez el 1 de julio del 2008 o posterior, para pagar los estudios de alguno de sus
  PLUS             hijos, o (2) si tiene actualmente un saldo pendiente de pago en algún préstamo hecho mediante el Programa FFEL antes del 1 de julio de 1993, o
                   (3) si tenía, en el momento de obtener otro préstamo que se desembolsó el 1 de julio de 1993 o posterior, un saldo pendiente de pago en algún
                   préstamo hecho antes del 1 de julio de 1993.
                   AVISO: El que a sabiendas haga declaraciones falsas o engañosas en el presente formulario, o en cualquier documento adjunto al mismo,
                   quedará sujeto a sanciones, las cuales pueden incluir las multas, el encarcelamiento o ambas penas, de conformidad con el Código Penal de
                   EE.UU. y con la Sección 1097 del Título 20 del Código de Estados Unidos.

SECCIÓN 1: DATOS PERSONALES DEL PRESTATARIO
                                                                                                   Favor de introducir o corregir la siguiente información:
                                                                                                   N.o de Seguro Social
                                                                                                   Nombre y apellido
                                                                                                   Dirección
                                                                                                   Ciudad, estado, código postal
                                                                                                   Teléfono (domicilio) (     )
                                                                                                   Teléfono (alternativo) (      )
                                                                                                   Correo electrónico (opcional)


SECCIÓN 2: SOLICITUD DE APLAZAMIENTO DE PAGO
Antes de responder a las preguntas, lea todo el formulario detenidamente, incluyendo las indicaciones y otra información que se hallan en las Secciones 5, 6 y 7.
  Cumplo con los requisitos, estipulados en la Sección 7, para acogerme al aplazamiento de pago por los motivos indicados abajo, y solicito que mi acreedor aplace el pago de mis
  préstamos mientras el estudiante (indicado abajo), en cuyo beneficio obtuve un Préstamo PLUS, (marque sólo una casilla):
       Cursa estudios, con una dedicación mínima de medio tiempo, en una institución educativa aprobada al efecto.
       Participa, con dedicación a tiempo completo, en un programa de rehabilitación y capacitación.
  Al marcar la casilla siguiente, también solicito el aplazamiento de pago de mis Préstamos Federales PLUS para padres que se han desembolsado por primera vez el 1 de julio
  del 2008 o posterior, por un período de seis meses posteriores a la fecha en que el estudiante (indicado abajo), en cuyo beneficio se obtuvo el préstamo, haya dejado de cursar
  estudios con una dedicación mínima de medio tiempo en una institución educativa aprobada al efecto.
       Solicito el aplazamiento de pago de mis Préstamos Federales PLUS que se han desembolsado por primera vez el 1 de julio del 2008 o posterior, por un período de seis
       meses posteriores a la fecha en que el estudiante indicado abajo haya dejado de cursar estudios con una dedicación mínima de medio tiempo en una institución educativa
       aprobada al efecto.

Nombre y apellido del estudiante                                                                          Número de Seguro Social del estudiante


SECCIÓN 3: ACEPTACIÓN, CERTIFICACIÓN Y AUTORIZACIÓN DEL PRESTATARIO
   Entiendo y acepto lo siguiente:
  (1) No tengo obligación de efectuar pagos al capital del préstamo durante la vigencia del aplazamiento de pago. Sin embargo, se me cobrarán los intereses producidos por mis
      préstamos.
  (2) Tengo la opción de pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (3) Puedo optar por pagar el interés, marcando la casilla de abajo. Mi acreedor podrá capitalizar los intereses que no se paguen durante el período de aplazamiento.
           Deseo pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (4) El aplazamiento de pago, otorgado por razón de estudios cursados en una institución educativa o por la participación en un programa de rehabilitación, entrará en vigor en la
      fecha de inicio de la condición que justificó el otorgamiento de tal beneficio, según certifique esta fecha el funcionario o empleado autorizado que llene la Sección 4 del
      presente formulario. El aplazamiento de pago vencerá en la primera de las dos fechas siguientes: la fecha en que ya no se cumpla con la condición que justificó tal beneficio o
      la fecha de terminación de dicha condición, según certifique la fecha el funcionario o empleado autorizado.
  (5) Si solicito el aplazamiento de pago por un período de seis meses posteriores a la fecha en que el estudiante haya dejado de cursar estudios con una dedicación mínima de
      medio tiempo, el aplazamiento entrará en vigor el día siguiente al cambio de dedicación de estudio y vencerá seis meses después de esa fecha.
  (6) Si el aplazamiento de pago no abarca todas las cuotas atrasadas, mi acreedor puede concederme un período de indulgencia de morosidad que abarque las que hayan
      vencido antes de la fecha de entrada en vigor del aplazamiento. En caso de que haya terminado el período de vigencia del aplazamiento, mi acreedor puede otorgarme un
      período de indulgencia que abarque toda cuota que haya vencido hasta la fecha de tramitación de la presente solicitud.
  (7) Mi acreedor puede concederme, según sea necesario, un período de indulgencia de morosidad por una duración máxima de 60 días, por motivo de la recopilación y
      tramitación de los documentos relativos a mi solicitud de aplazamiento de pago. No se capitalizarán los intereses producidos durante el plazo de vigencia de este tipo de
      indulgencia.
   Certifico lo siguiente: (1) que la información que proporcioné en las Secciones 1 y 2, arriba, es correcta y verídica; (2) que aportaré documentación complementaria a mi
   acreedor, según sea necesario, que acredite las circunstancias en cuya virtud me acojo al aplazamiento de pago; (3) que avisaré a mi acreedor, de forma inmediata, una vez que
   hayan terminado las condiciones que justificaron el aplazamiento de pago, y (4) que he leído, entendido y cumplido los requisitos y condiciones cuya satisfacción es necesaria
   para la concesión del aplazamiento de pago por los motivos señalados en el presente formulario de solicitud, según lo expuesto en la Sección 7.
   Autorizo a la institución educativa, al acreedor, al garante, al Departamento y a sus respectivos agentes y contratistas a comunicarse conmigo respecto a mis préstamos, incluido
   el pago de los mismos, al número actual o futuro (si lo proporciono) de mi teléfono móvil u otro dispositivo inalámbrico, por medio de sistemas de marcado automático, mensajes
   de texto o mensajes de voz artificial o grabados.

Firma del prestatario                                                                                                                                   Fecha




                                                                                       Página 1 de 4
SECCIÓN 4: CERTIFICACIÓN DEL FUNCIONARIO O EMPLEADO AUTORIZADO
Certifico que, según mi leal saber y entender, el alumno dependiente arriba indicado está o estuvo matriculado en una institución aprobada, o participa o participó en el programa
indicado en la Sección 2 del presente formulario, y que el alumno y (si corresponde) el programa educativo de éste cumplen todos los requisitos estipulados en la Sección 7, en la
página siguiente.
     Está o estuvo matriculado para cursar estudios con una dedicación mínima de medio tiempo, durante el período académico comprendido entre el
                                             y el                                      y que se prevé, con un grado razonable de confiabilidad, que cumpla el programa de estudios
     el                                        .
     Participa o participó, con dedicación a tiempo completo, en un programa de rehabilitación y capacitación que empezó el                                          y que terminó o
     terminará el                                      .

Nombre de institución o centro                                                                                        OPE-ID (si corresponde)

Dirección                                                                                                             Ciudad, estado, código postal

Nombre, apellido y puesto
del funcionario o empleado
autorizado                                                                                                            Teléfono (     )

Firma del funcionario
o empleado autorizado                                                                                                 Fecha

SECCIÓN 5: INSTRUCCIONES PARA LLENAR EL FORMULARIO
Escriba sus respuestas a máquina o con letra de molde y tinta oscura. Escriba las fechas en el formato mes-día-año (MM-DD-AAAA). Por ejemplo, «31 de enero de 2009» equivale
a «01-31-2009». La Sección 4 la deberá rellenar un funcionario o empleado autorizado. Si usted necesita ayuda para llenar el presente formulario, comuníquese con su acreedor.
Remita el formulario con los datos completos, y cualquier documentación solicitada, a la dirección indicada en la Sección 8.
SECCIÓN 6: DEFINICIONES
  El acreedor de mis préstamos del Programa FFEL puede ser una entidad prestamista, garante o financiera (del mercado secundario), o el Departamento de Educación de EE.UU.
   El aplazamiento de pago consiste en un período durante el cual tengo derecho a posponer el pago del capital de mis préstamos. El Departamento de Educación de EE.UU.
   sufraga los intereses producidos durante el aplazamiento de pago debidamente tramitado, todo Préstamo Federal Stafford con subsidio del interés y todo Préstamo Federal de
   Consolidación cuya solicitud llegó a mi acreedor (1) el 1 de enero de 1993 o posterior pero antes del 10 de agosto de 1993, (2) el 10 de agosto de 1993 o posterior, siempre que
   la solicitud incluyera sólo los Préstamos Federales Stafford que gozaban del subsidio federal del interés, o (3) el 13 de noviembre de 1997 o posterior, cuando se trate de la
   porción del préstamo de consolidación con la que se liquidó un préstamo educativo con subsidio del interés obtenido del Programa FFEL o del Direct Loan ProgramSM. Tengo la
   responsabilidad de pagar los intereses producidos durante este período por cualquier otro préstamo hecho al amparo del Programa FFEL.
   La capitalización consiste en añadir los intereses pendientes de pago al saldo de capital del préstamo. El saldo de capital del préstamo aumenta cuando se postergan los pagos,
   durante los períodos de aplazamiento de pago o de indulgencia de morosidad, y se capitalizan los intereses. Como resultado de esto, puede que se produzcan más intereses
   durante la vigencia del préstamo, que se aumente la cantidad de la cuota mensual o que se incremente el número de los pagos. En el cuadro siguiente, se presentan cálculos
   aproximados de las cuotas mensuales de un préstamo sin subsidio del interés, hecho por un monto de $15,000 y con una tasa de 9 por ciento, después de un período de aplaza-
   miento de pago de 12 meses de duración. Se comparan los efectos de las diferentes maneras de tratar los intereses del préstamo: pagarlos a medida que se van produciendo,
   capitalizarlos al final del período de aplazamiento de pago y capitalizarlos trimestralmente y al final del período de aplazamiento de pago. El costo efectivo de los intereses de mi
   préstamo dependerá de la tasa de interés, de la duración del aplazamiento de pago y de la frecuencia de capitalización de los intereses. Como se puede apreciar en el cuadro, si
   los intereses se van pagando durante el período del aplazamiento de pago, la cuota mensual se rebaja en unos $18 y se ahorran casi $772 durante la vigencia del préstamo.
       Tratamiento de los intereses producidos          Cantidad del        Intereses capitalizados       Capital a        Cuota          Número                       Total pagado
                                                                                                                                                      Total pagado
             durante el aplazamiento de pago             préstamo                 (12 meses)               pagar          mensual        de cuotas                     en intereses
      Pagar los intereses durante
                                                         $15,000.00                  $0.00               $15,000.00       $190.01          120        $24,151.64*       $9,151.64
      el aplazamiento de pago
      Capitalizar los intereses al final
                                                         $15,000.00                $1,350.00             $16,350.00       $207.11          120         $24,853.79       $9,853.79
      del aplazamiento de pago
      Capitalizar los intereses cada
       trimestre durante el aplazamiento                 $15,000.00                $1,396.25             $16,396.25       $207.70          120         $24,924.09       $9,924.09
      de pago y al final del mismo
   * El total pagado incluye los $1,350 de intereses pagados durante los 12 meses del aplazamiento de pago.
   El Federal Family Education Loan Program (Programa FFEL) incluye los Préstamos Federales Stafford (con y sin subsidio del interés), los Préstamos Federales
   Suplementarios para Estudiantes (SLS), los Préstamos Federales PLUS y los Préstamos Federales de Consolidación.
   Funcionarios y empleados autorizados para certificar los datos consignados:
   • Funcionario o empleado autorizado de la institución educativa (si el alumno está matriculado para estudiar, con dedicación de tiempo completo o de al menos medio tiempo, en
     una institución aprobada)
   • Funcionario o empleado autorizado del programa de rehabilitación y capacitación
   Indulgencia de morosidad se refiere a la suspensión temporal de las cuotas del préstamo, a la prolongación del plazo de vencimiento de las cuotas o a la reducción temporal de
   la cantidad programada de las cuotas. Tengo la responsabilidad de pagar los intereses producidos por mis préstamos durante el período de indulgencia de morosidad. Si no
   pago los intereses, éstos pueden capitalizarse.




                                                                                   Página 2 de 4
SECCIÓN 7: REQUISITOS PARA ACOGERSE AL APLAZAMIENTO DE PAGO PARA PADRES CON PRÉSTAMOS PLUS
Para poder acogerme al aplazamiento de pago por este motivo, debe cumplirse lo siguiente:
  Si tengo un saldo pendiente de pago en algún Préstamo Federal PLUS que se desembolsó por primera vez el 1 de julio del 2008 o posterior, puedo aplazar el pago del mismo
  mientras el estudiante en cuyo beneficio obtuve el préstamo cursa estudios, con una dedicación mínima de medio tiempo, en una institución educativa aprobada al efecto.
  Si mi Préstamo Federal PLUS para padres se desembolsó por primera vez el 1 de julio del 2008 o posterior, puedo aplazar el pago del mismo por un período de seis meses
  posteriores a la fecha en que el estudiante haya dejado de cursar estudios con una dedicación mínima de medio tiempo en una institución educativa aprobada al efecto.
  Si tengo un saldo pendiente de pago en algún préstamo hecho mediante el Programa FFEL el 1 de julio de 1987 o posterior, pero antes del 1 de julio de 1993, o si tenía, en el
  momento de obtener otro préstamo que se desembolsó el 1 de julio de 1993 o posterior, un saldo pendiente de pago en algún préstamo hecho antes del 1 de julio de 1993,
  puede aplazar el pago de mis préstamos mientras el estudiante en cuyo beneficio obtuve un Préstamo Federal PLUS es dependiente y:
   • Cursa estudios, con una dedicación mínima de medio tiempo, en una institución educativa aprobada al efecto.
   • Participa, con dedicación a tiempo completo, en un programa de rehabilitación y capacitación. Para poder acogerme al aplazamiento de pago por este motivo, debe cumplirse
     lo siguiente: (1) El programa en referencia debe: (a) contar con la pertinente licencia, autorización, certificación o reconocimiento —expedidos por el Departamento de Asuntos
     de Veteranos o por el organismo del estado correspondiente que se encarga de los programas de rehabilitación profesional, de tratamiento de drogadictos, de salud mental o
     de tratamiento de alcohólicos— que sea necesario para la prestación de servicios de rehabilitación y capacitación a personas con discapacidad; (b) prestar servicios conforme
     a un plan, en forma escrita, elaborado según las necesidades del cliente y en el que se especifique la fecha prevista de terminación de los servicios, y (c) ser organizado de
     manera que suponga un compromiso importante por parte del estudiante con su propia rehabilitación. («Compromiso importante» significa un compromiso de tiempo y
     esfuerzo que, en circunstancias normales, impediría a una persona trabajar 30 horas semanales o más en un puesto con una duración mínima prevista de tres meses.) (2) La
     prestación de los servicios de rehabilitación debe estar en marcha o programada para ponerse en marcha.




                                                                                 Página 3 de 4
SECCIÓN 8: DÓNDE ENVIAR EL FORMULARIO CON LOS DATOS COMPLETOS
Envíe el formulario con los datos completos, y cualquier otra documentación necesaria, a       Si necesita ayuda para llenar el formulario, llame al siguiente número:
la siguiente dirección:                                                                        (De no indicarse ningún número de teléfono, llame a su acreedor.)
(De no indicarse ninguna dirección, remita el formulario a su acreedor.)




SECCIÓN 9: AVISOS IMPORTANTES
Aviso sobre la Ley de Confidencialidad de Información
En virtud de la Ley de Confidencialidad de Información de 1974 (Sección 552a del Título 5 del Código de Estados Unidos), es obligatorio poner a disposición del solicitante el
siguiente aviso:
La autoridad para reunir la información solicitada por medio del presente formulario deriva de la Sección 421 y siguientes de la Ley de Educación Superior de 1965, según
enmendada (Sección 1071 y siguientes del Título 20 del Código de Estados Unidos). La autoridad para solicitar y utilizar el número de Seguro Social del solicitante deriva de la
Sección 484(a)(4) de la Ley de Educación Superior (Sección 1091[a][4] del Título 20 del Código de Estados Unidos) y de la Sección 7701(b) del Título 30 del Código de Estados
Unidos. Si bien tienen carácter voluntario tanto la participación en el Federal Family Education Loan Program (Programa FFEL) como el proporcionar el número de Seguro Social, el
solicitante deberá facilitar la información solicitada, incluido el número de Seguro Social, para poder participar en el Programa.
La reunión de la información solicitada en el presente formulario (incluido el número de Seguro Social) se realiza con los siguientes fines principales: verificar la identidad del
solicitante; determinar el otorgamiento, al amparo del Programa FFEL, de préstamos nuevos o de beneficios en materia del pago de préstamos existentes (como por ejemplo, el
aplazamiento de pago, la indulgencia de morosidad, y la anulación o condonación de deudas); administrar los préstamos del solicitante, y, en caso de mora o incumplimiento de
pago, localizarlo, exigirle el pago de la deuda e informar a las entidades competentes la condición de los préstamos. También hacemos uso del número de Seguro Social como
identificador de la cuenta de préstamos del solicitante y para permitir a éste acceder electrónicamente a los datos relativos a la misma.
Al amparo de una cláusula, debidamente publicada en el sistema de registro de datos correspondiente, relativa al uso normal de la información recogida, los datos que se encuentran
en el expediente del solicitante se pueden poner a disposición de terceras entidades, ya sea según las circunstancias particulares del caso o en cumplimiento de un programa de
cotejo electrónico de datos. Tratándose del presente formulario, el uso normal de esta información incluye, sin carácter limitativo, la cesión de los datos a ciertas partes, señaladas
abajo, a fin de hacer lo siguiente: verificar la identidad del solicitante; determinar el otorgamiento de préstamos nuevos o de beneficios en materia del pago de préstamos existentes;
permitir la administración o cobro de los préstamos; hacer cumplir los términos y condiciones de los préstamos; investigar la posible comisión de fraude y verificar el cumplimiento de
las normas que rigen los programas federales de ayuda económica para los estudios superiores o localizar al solicitante en caso de mora o incumplimiento de pago. Las siguientes
son las partes a las que podemos destinar la información reunida: organismos federales, estatales y locales; particulares que tienen alguna relación con el solicitante, tales como
familiares, empleadores actuales y pasados, socios comerciales y personales; agencias de informes crediticios; instituciones educativas y financieras, y garantes. Para informar
sobre los cálculos del índice de incumplimiento de pago, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos estatales. Para facilitar el
historial de ayuda económica del solicitante, podemos ceder los datos a instituciones educativas. Para ayudar a los administradores del programa a llevar un control sobre la
devolución de fondos de préstamo y la anulación de préstamos, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos federales o estatales.
Para establecer un método estandarizado según el cual instituciones educativas puedan informar de forma eficiente sobre la dedicación de estudio del solicitante, podemos ceder los
datos a garantes o a instituciones financieras y educativas. Para dar orientación al solicitante en materia del pago de préstamos, podemos ceder los datos a garantes, a instituciones
financieras y educativas, o a organismos federales, estatales o locales.
En caso de litigio, podemos enviar los datos del solicitante al Departamento de Justicia, o al tribunal, entidad jurídica, abogado, parte o testigo correspondientes, cuando dicha cesión
se considere procedente y necesaria para la solución del mismo. Si estos datos, ya sean por separado o en conjunto con otra información, indican una posible violación de la ley,
podemos enviarlos a las autoridades competentes, para que se tomen las medidas pertinentes. Podemos enviar la información a congresistas en caso que usted les pida ayuda con
algún problema relacionado con los programas federales de asistencia estudiantil. En caso de denuncias, quejas o medidas disciplinarias en materia de empleo, podemos ceder los
datos a las entidades competentes, a fin de facilitar la adjudicación o investigación de las mismas. Si así se dispone en una convención colectiva de trabajo, podemos ceder los
datos a los sindicatos debidamente reconocidos al amparo del Capítulo 71 del Título 5 del Código de Estados Unidos. Podemos poner los datos a disposición de nuestros
contratistas si los necesitan para realizar funciones relacionadas con los programas en referencia. Antes de hacerlo, requerimos que el contratista ponga en práctica las medidas de
protección necesarias para cumplir con la Ley de Confidencialidad de Información. Los datos también pueden cederse, de conformidad con las protecciones previstas en la Ley de
Confidencialidad de Información, a aquellos investigadores que reúnan los requisitos correspondientes.
Aviso sobre la Ley de Reducción de Trámites
Según lo dispuesto en la Ley de Reducción de Trámites de 1995, ninguna persona estará en la obligación de responder a un instrumento de recolección de datos que no exhiba un
número de control vigente emitido por la Oficina de Administración y Presupuesto (OMB, por sus siglas en inglés). Para efectos del presente formulario, dicho número es 1845-0005.
Se calcula que se necesitan, como promedio, 0.16 horas (10 minutos) por respuesta, incluido el tiempo para leer las instrucciones, buscar la información en los documentos
correspondientes, reunir los datos necesarios, consignarlos en el formulario y revisarlos. Si usted tiene algún comentario sobre la exactitud de estos cálculos, o alguna
sugerencia sobre cómo mejorar el presente formulario, escriba a la siguiente dirección:
U.S. Department of Education, Washington, DC 20202-4537
Si tiene preguntas sobre el estado de tramitación de su formulario, escriba a la dirección indicada en la Sección 8.




                                                                                   Página 4 de 4
                     PUBLIC SERVICE DEFERMENT REQUEST                                                                                                             OMB No. 1845-0005
                                                                                                                                                                  Form Approved
                     Federal Family Education Loan Program                                                                                                        Exp. Date 05/31/2012

                     Use this form only if you have an outstanding balance on a Federal Family Education Loan Program loan that was made before July 1, 1993, or had
                     a balance on a loan that was made before July 1, 1993, at the time you obtained a loan disbursed on or after July 1, 1993.
                     WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents is subject to
    PUB              penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.

SECTION 1: BORROWER IDENTIFICATION
                                                                                                     Please enter or correct the following information.
                                                                                                     SSN |__|__|__|-|__|__|-|__|__|__|__|
                                                                                                     Name
                                                                                                     Address
                                                                                                     City, State, Zip Code
                                                                                                     Telephone - Home (        )
                                                                                                     Telephone - Other (       )
                                                                                                     E-mail Address (Optional)
SECTION 2: DEFERMENT REQUEST
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 5, 6, and 7.
 I meet the qualifications stated in Section 7 for the deferment checked below and request that my loan holder defer repayment of my loan(s) while I am:
       On active duty in the ARMED FORCES of the United States.
       Serving full time as an officer in the Commissioned Corps of the PUBLIC HEALTH SERVICE.
       Serving in the PEACE CORPS.
       A full-time paid volunteer in the ACTION PROGRAMS.
       A full-time paid volunteer for a TAX-EXEMPT ORGANIZATION.
       On active duty in the NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION (NOAA).
        The NOAA Deferment is available only to Federal Stafford and SLS loan borrowers whose first loans were made on or after July 1, 1987, and before July 1, 1993, or
        borrowers who had a balance on a loan that was made on or after July 1, 1987, and before July 1, 1993, at the time a loan was disbursed on or after July 1, 1993.
   NOTE: Federal PLUS Loans made on or after August 15, 1983, and Federal Consolidation Loans do not qualify for these deferments.
SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
 I understand that:
   (1) I am not required to make payments of loan principal during my deferment. Interest will not be charged on my subsidized loan(s) during my deferment. However, interest will
       be charged on my unsubsidized loan(s).
   (2) I have the option of paying the interest that accrues on my unsubsidized loan(s) during my deferment.
   (3) I may choose to make interest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period.
            I wish to make interest payments on my unsubsidized loan(s) during my deferment.
   (4) My deferment will begin on the date I began performing the public service that qualifies me for the deferment, as certified by the authorized official who completes Section 4 of
       this form.
   (5) My deferment will end on the earlier of the date that I stop performing the public service that qualifies me for the deferment, or the ending date of my qualifying public service, as
       certified by the authorized official.
   (6) If my deferment does not cover all my past due payments, my loan holder may grant me a forbearance for all payments due before the begin date of my deferment or—if the
       period for which I am eligible for a deferment has ended—a forbearance for all payments due at the time my deferment request is processed.
   (7) My loan holder may grant me a forbearance on my loans for up to 60 days, if necessary, for the collection and processing of documentation related to my deferment request.
       Interest that accrues during the forbearance will not be capitalized.
 I certify that: (1) The information I provided in Sections 1 and 2 above is true and correct. (2) I will provide additional documentation to my loan holder, as required, to support my
   deferment status. (3) I will notify my loan holder immediately when the condition(s) that qualified me for the deferment ends. (4) I have read, understand, and meet the eligibility
   criteria of the deferment for which I have applied, as explained in Section 7.
 I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to contact me regarding my loan(s), including repayment of my
   loan(s), at the current or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded
   voice or text messages.
Borrower’s Signature                                                                                                                     Date

SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION
I certify, to the best of my knowledge and belief, that the borrower named above is/was engaged in the service indicated in Section 2, and that the borrower and the borrower’s service
meet all the eligibility requirements specified in Section 7.
The borrower’s service began on |__|__|-|__|__|-|__|__|__|__| and is expected to end/ended on |__|__|-|__|__|-|__|__|__|__|.
Name of Organization
Address                                                                                                                   City, State, Zip Code
Name/Title of Authorized Official                                                                                         Telephone (          )
Authorized Official’s Signature                                                                                           Date

                                                                                           Page 1 of 3
SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Report dates as month-day-year (MM-DD-YYYY). For example, ‘January 31, 2009’ = ‘01-31-2009’. An authorized official must either complete Section 4
or attach the organization’s own certification listing the required information. If you need help completing this form, contact your loan holder.
Return the completed form and any required documentation to the address shown in Section 8.
SECTION 6: DEFINITIONS
 Authorized certifying officials:
   •   Commanding or Personnel Officer (Armed Forces Deferment)
   •   Authorized Official of the U. S. Public Health Service (Public Health Service Deferment)
   •   Authorized Official of the Peace Corps (Peace Corps Deferment)
   •   Authorized Official of the ACTION Program (ACTION Program Deferment)
   •   Authorized Official of the Volunteer Program (Tax-Exempt Organization Deferment)
   •   Authorized Official of the NOAA Corps (NOAA Deferment)
 Capitalization is the addition of unpaid interest to the principal balance of my loan. The principal balance of a loan increases when payments are postponed during periods of
  deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more
  payments may be required. The chart below provides estimates, for a $15,000 unsubsidized loan balance at a 9% interest rate, of the monthly payments due following a 12-month
  deferment. It compares the effects of paying the interest as it accrues, capitalizing the interest at the end of the deferment, and capitalizing interest quarterly and at the end of the
  deferment. My actual loan interest cost will depend on my interest rate, length of the deferment, and frequency of capitalization. Paying interest during the period of deferment
  lowers the monthly payment by about $18 and saves about $772 over the lifetime of the loan, as depicted in the chart below.
             Treatment of Interest Accrued                 Loan         Capitalized Interest    Principal to           Monthly       Number of       Total Amount        Total Interest
                     During Deferment                     Amount          for 12 Months           Be Repaid            Payment       Payments           Repaid               Paid
      Interest is paid                                   $15,000.00            $0.00             $15,000.00            $190.01          120           $24,151.64*         $9,151.64
      Interest is capitalized at the end of deferment    $15,000.00          $1,350.00           $16,350.00            $207.11          120           $24,853.79          $9,853.79
      Interest is capitalized quarterly during
                                                         $15,000.00          $1,396.25           $16,396.25            $207.70           120           $24,924.09          $9,924.09
      deferment and at the end of deferment
   *Total amount repaid includes $1,350 of interest paid during the 12-month period of deferment.
 A deferment is a period during which I am entitled to postpone repayment of the principal balance of my loan(s). The federal government pays the interest that accrues during an
  eligible deferment for all subsidized Federal Stafford Loans and for Federal Consolidation Loans for which the Consolidation Loan application was received by my loan holder (1)
  on or after January 1, 1993, but before August 10, 1993, (2) on or after August 10, 1993, if it includes only Federal Stafford Loans that were eligible for federal interest subsidy, or
  (3) on or after November 13, 1997, for that portion of the Consolidation Loan that paid a subsidized FFEL Program loan or a subsidized Federal Direct Loan. I am responsible for
  the interest that accrues during this period on all other FFEL Program loans.
 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal Supplemental Loans for Students (SLS),
  Federal PLUS Loans, and Federal Consolidation Loans.
 Forbearance means permitting the temporary cessation of payments, allowing an extension of time for making payments, or temporarily accepting smaller payments than
  previously scheduled. I am responsible for paying the interest that accrues on my loan(s) during a forbearance. If I do not pay the interest that accrues, the interest may be
  capitalized.
 The holder of my FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the U.S. Department of Education.
SECTION 7: ELIGIBILITY CRITERIA FOR PUBLIC SERVICE DEFERMENT REQUEST
 To qualify for any of the deferments listed in Section 2 of this form:
   • I must have an outstanding balance on a FFEL Program loan which was made before July 1, 1993, or I must have had an outstanding balance on a FFEL Program loan made
      before July 1, 1993, when I obtained a loan disbursed on or after July 1, 1993. If I am a Federal PLUS Loan borrower, (1) I am not eligible for the NOAA Deferment, and (2) I
      am eligible for the Armed Forces, Public Health Service, Peace Corps, ACTION Programs, and Tax-Exempt Organization Deferments only on the loan(s) made before August
      15, 1983. I am eligible for the NOAA Deferment only if I am a Federal Stafford or SLS loan borrower whose first loan was made on or after July 1, 1987, and before July 1,
      1993, or I had an outstanding balance on a loan made on or after July 1, 1987, and before July 1, 1993, when I obtained a loan on or after July 1, 1993.
 I may defer repayment of my loan(s) while I am:
   • On active duty in the ARMED FORCES of the United States. (Maximum eligibility is 3 years; this is a combined limit with Public Health Service and NOAA deferments.) To
     qualify, I must: (1) be on active duty in the Army, Navy, Air Force, Marine Corps or Coast Guard, and (2) provide my loan holder with copies of my military identification and
     orders or have my commanding or personnel officer certify Section 4 on the front of this form. Note: Borrowers enlisted in a reserve component of the Armed Forces or the
     National Guard (while on active duty status in the Army or Air Force Reserves) may qualify for this deferment only if: (1) serving full time for a period expected to last at least 1
     year, or (2) serving under an order for national mobilization.
   • Serving full time as an officer in the Commissioned Corps of the PUBLIC HEALTH SERVICE. (Maximum eligibility is 3 years; this is a combined limit with Armed Forces and
     NOAA deferments.)
   • Serving in the PEACE CORPS. (Maximum eligibility is 3 years.) To qualify, I must have agreed to serve for a period of at least 1 year. Note: As an alternative to having an
     authorized Peace Corps official complete Section 4 of this form, you may provide your loan holder with documentation of the beginning and expected ending dates of your
     service in the Peace Corps. This documentation must be signed and dated by an authorized Peace Corps official.
   • A full-time paid volunteer in the ACTION PROGRAMS. (Maximum eligibility is 3 years.) To qualify, I must have agreed to serve for a period of at least 1 year.
   • A full-time paid volunteer for a TAX-EXEMPT ORGANIZATION. (Maximum eligibility is 3 years.) To qualify, I must: (1) be serving full time in an organization that has a tax
     exemption under Section 501(c)(3) of the Internal Revenue Code of 1986; (2) assist low income people and their communities in eliminating poverty and poverty-related human,
     social, and environmental conditions; (3) not earn more than the federal minimum wage; however, I may receive fringe benefits like those received by other employees of the
     organization; (4) not engage in religious instruction, proselytizing, fund-raising to support religious activities, or conduct worship services as part of my duties; and (5) have
     agreed to serve for a period of at least 1 year.
   • On active duty in the NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION (NOAA). (Maximum eligibility is 3 years; this is a combined limit with Armed Forces and
     Public Health Service Deferments.)




                                                                                      Page 2 of 3
SECTION 8: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST
Return the completed deferment request and any required documentation to:                         If you need help completing this form, call:
(If no address is shown, return to your loan holder.)                                             (If no telephone number is shown, call your loan holder.)




SECTION 9: IMPORTANT NOTICES
Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §421 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and the
authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family
Education Loan Program (FFELP) and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
(such as a deferment, forbearance, discharge, or forgiveness) under the FFELP, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and
report on your loan(s) if your loan(s) becomes delinquent or in default. We also use your SSN as an account identifier and to permit you to access your account information
electronically.
The information in your file may be disclosed, on a case-by-case basis or under a computer matching program, to third parties as authorized under routine uses in the appropriate
systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local agencies, to private parties such as relatives,
present and former employers, business and personal associates, to consumer reporting agencies, to financial and educational institutions, and to guaranty agencies in order to verify
your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s), to investigate
possible fraud and to verify compliance with federal student financial aid program regulations, or to locate you if you become delinquent in your loan payments or if you default. To
provide default rate calculations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history
information, disclosures may be made to educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal or state agencies. To provide a standardized method for educational institutions to efficiently submit student enrollment
status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in repayment efforts, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to the
litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate authority for action. We may send
information to members of Congress if you ask them to help you with federal student aid questions. In circumstances involving employment complaints, grievances, or disciplinary
actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective bargaining agreement, we may disclose records to a labor organization
recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for the purpose of performing any programmatic function that requires disclosure of records.
Before making any such disclosure, we will require the contractor to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act
safeguards.
Paperwork Reduction Notice
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The
valid OMB control number for this information collection is 1845-0005. The time required to complete this information collection is estimated to average 0.16 hours (10 minutes) per
response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and complete and review the information collection. If you
have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, DC 20202-4537
If you have questions regarding the status of your individual submission of this form, write directly to the address shown in Section 8.




                                                                                        Page 3 of 3
                    SOLICITUD DE APLAZAMIENTO DE PAGO:                                                                                                               N.o de OMB: 1845-0005
                                                                                                                                                                     Formulario aprobado

                    SERVICIO PÚBLICO                                                                                                                                 Caduca: 31 mayo 2012

                    Federal Family Education Loan ProgramSM
                    Sólo utilice el presente formulario si tiene un saldo pendiente de pago en algún préstamo hecho mediante el programa de préstamos educativos
   PUB              Federal Family Education Loan Program (FFELSM) antes del 1 de julio de 1993, o si tenía, en el momento de obtener un préstamo que se
                    desembolsó el 1 de julio de 1993 o posterior, un saldo pendiente de pago en algún préstamo hecho antes del 1 de julio de 1993.
                    AVISO: El que a sabiendas haga declaraciones falsas o engañosas en el presente formulario, o en cualquier documento adjunto al mismo, quedará
                    sujeto a sanciones, las cuales pueden incluir las multas, el encarcelamiento o ambas penas, de conformidad con el Código Penal de EE.UU. y con
                    la Sección 1097 del Título 20 del Código de Estados Unidos.

SECCIÓN 1: DATOS PERSONALES DEL PRESTATARIO
                                                                                                    Favor de introducir o corregir la siguiente información:
                                                                                                    N.o de Seguro Social
                                                                                                    Nombre y apellido
                                                                                                    Dirección
                                                                                                    Ciudad, estado, código postal
                                                                                                    Teléfono (domicilio) (     )
                                                                                                    Teléfono (alternativo) (     )
                                                                                                    Correo electrónico (opcional)
SECCIÓN 2: SOLICITUD DE APLAZAMIENTO DE PAGO
Antes de responder a las preguntas, lea todo el formulario detenidamente, incluyendo las indicaciones y otra información que se hallan en las Secciones 5, 6 y 7.
   Cumplo con los requisitos, estipulados en la Sección 7, para acogerme al aplazamiento de pago por el motivo indicado abajo, y solicito que mi acreedor aplace el pago de mis
   préstamos mientras:
      Presto servicio activo en las FUERZAS ARMADAS de los Estados Unidos.
      Presto servicio a tiempo completo en calidad de oficial en el Cuerpo de Comisionados del SERVICIO DE SALUD PÚBLICA.
      Presto servicio en el CUERPO DE PAZ.
      Presto servicio a tiempo completo como voluntario en los PROGRAMAS ACTION.
      Presto servicio a tiempo completo como voluntario en una ENTIDAD EXENTA DE IMPUESTOS.
      Presto servicio activo en la ADMINISTRACIÓN NACIONAL DE OCÉANOS Y ATMÓSFERA (NOAA).
       El aplazamiento por servicio en la NOAA sólo se otorga al prestatario que haya obtenido Préstamos Federales Stafford o Préstamos Federales Suplementarios para
       Estudiantes (SLS) por primera vez el 1 de julio de 1987 o posterior pero antes del 1 de julio de 1993, o al prestatario que tuviera, en el momento de obtener otro préstamo
       que se desembolsó el 1 de julio de 1993 o posterior, un saldo pendiente en algún préstamo hecho el 1 de julio de 1987 o posterior pero antes del 1 de julio de 1993.
   NOTA: Tratándose de los Préstamos Federales PLUS hechos el 15 de agosto de 1983 o posterior, y de los Préstamos Federales de Consolidación, el prestatario no puede
   acogerse al aplazamiento de pago por los motivos antedichos.
SECCIÓN 3: ACEPTACIÓN, CERTIFICACIÓN Y AUTORIZACIÓN DEL PRESTATARIO
   Entiendo y acepto lo siguiente:
  (1) No tengo obligación de efectuar pagos al capital del préstamo durante la vigencia del aplazamiento de pago. Durante este período, no se me cobrarán los intereses producidos
      por mis préstamos que tengan subsidio del interés. Sin embargo, se me cobrarán los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (2) Tengo la opción de pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (3) Puedo optar por pagar el interés, marcando la casilla de abajo. Mi acreedor podrá capitalizar los intereses que no se paguen durante el período de aplazamiento.
           Deseo pagar, durante el aplazamiento de pago, los intereses producidos por mis préstamos que no tengan subsidio del interés.
  (4) El aplazamiento de pago entrará en vigor en la fecha de inicio de la prestación de servicio público que justificó el otorgamiento de tal beneficio, según certifique esta fecha el
      funcionario o empleado autorizado que llene la Sección 4 del presente formulario.
  (5) El aplazamiento de pago vencerá en la primera de las dos fechas siguientes: la fecha en que deje de prestar el servicio público que justificó el otorgamiento de tal beneficio o la
      fecha de terminación de dicho servicio, según certifique la fecha el funcionario o empleado autorizado.
  (6) Si el aplazamiento de pago no abarca todas las cuotas atrasadas, mi acreedor puede concederme un período de indulgencia de morosidad que abarque las que hayan vencido
      antes de la fecha de entrada en vigor del aplazamiento. En caso de que haya terminado el período de vigencia del aplazamiento, mi acreedor puede otorgarme un período de
      indulgencia que abarque toda cuota que haya vencido hasta la fecha de tramitación de la presente solicitud.
  (7) Mi acreedor puede concederme, según sea necesario, un período de indulgencia de morosidad por una duración máxima de 60 días, por motivo de la recopilación y tramitación
      de los documentos relativos a mi solicitud de aplazamiento de pago. No se capitalizarán los intereses producidos durante el plazo de vigencia de este tipo de indulgencia.
   Certifico lo siguiente: (1) que la información que proporcioné en las Secciones 1 y 2, arriba, es correcta y verídica; (2) que aportaré documentación complementaria a mi
   acreedor, según sea necesario, que acredite las circunstancias en cuya virtud me acojo al aplazamiento de pago; (3) que avisaré a mi acreedor, de forma inmediata, una vez que
   hayan terminado las condiciones que justificaron el aplazamiento de pago, y (4) que he leído, entendido y cumplido los requisitos y condiciones cuya satisfacción es necesaria
   para la concesión del aplazamiento de pago por los motivos señalados en el presente formulario de solicitud, según lo expuesto en la Sección 7.
  Autorizo a la institución educativa, al acreedor, al garante, al Departamento y a sus respectivos agentes y contratistas a comunicarse conmigo respecto a mis préstamos, incluido
  el pago de los mismos, al número actual o futuro (si lo proporciono) de mi teléfono móvil u otro dispositivo inalámbrico, por medio de sistemas de marcado automático, mensajes
  de texto o mensajes de voz artificial o grabados.
Firma del prestatario                                                                                                                         Fecha




                                                                                        Página 1 de 4
SECCIÓN 4: CERTIFICACIÓN DEL FUNCIONARIO O EMPLEADO AUTORIZADO
Certifico que, según mi leal saber y entender, el prestatario arriba indicado presta o prestó el servicio indicado en la Sección 2 del presente formulario, y que el prestatario y el
servicio prestado cumplen todos los requisitos estipulados en la Sección 7.
El servicio docente prestado por el prestatario empezó o empezará el                                          y terminó o está previsto terminar el                                       .
Nombre de entidad
Dirección                                                                                                          Ciudad, estado, código postal
Nombre, apellido y puesto del
funcionario o empleado autorizado                                                                                  Teléfono (          )
Firma del funcionario o
empleado autorizado                                                                                                 Fecha

SECCIÓN 5: INSTRUCCIONES PARA LLENAR EL FORMULARIO
Escriba sus respuestas a máquina o con letra de molde y tinta oscura. Escriba las fechas en el formato mes-día-año (MM-DD-AAAA). Por ejemplo, «31 de enero de 2009» equivale a
«01-31-2009». El funcionario o empleado autorizado deberá rellenar la Sección 4 o adjuntar la certificación, facilitada por la entidad, en la que figure la información necesaria. Si
usted necesita ayuda para llenar el presente formulario, comuníquese con su acreedor.
Remita el formulario con los datos completos, y cualquier documentación solicitada, a la dirección indicada en la Sección 8.
SECCIÓN 6: DEFINICIONES
   El acreedor de mis préstamos del Programa FFEL puede ser una entidad prestamista, garante o financiera (del mercado secundario), o el Departamento de Educación de EE.UU.
   El aplazamiento de pago consiste en un período durante el cual tengo derecho a posponer el pago del capital de mis préstamos. El Departamento de Educación de EE.UU.
   sufraga los intereses producidos durante el aplazamiento de pago debidamente tramitado, todo Préstamo Federal Stafford con subsidio del interés y todo Préstamo Federal de
   Consolidación cuya solicitud llegó a mi acreedor (1) el 1 de enero de 1993 o posterior pero antes del 10 de agosto de 1993, (2) el 10 de agosto de 1993 o posterior, siempre que la
   solicitud incluyera sólo los Préstamos Federales Stafford que gozaban del subsidio federal del interés, o (3) el 13 de noviembre de 1997 o posterior, cuando se trate de la porción
   del préstamo de consolidación con la que se liquidó un préstamo educativo con subsidio del interés obtenido del Programa FFEL o del Direct Loan ProgramSM. Tengo la
   responsabilidad de pagar los intereses producidos durante este período por cualquier otro préstamo hecho al amparo del Programa FFEL.
   La capitalización consiste en añadir los intereses pendientes de pago al saldo de capital del préstamo. El saldo de capital del préstamo aumenta cuando se postergan los pagos,
   durante los períodos de aplazamiento de pago o de indulgencia de morosidad, y se capitalizan los intereses. Como resultado de esto, puede que se produzcan más intereses
   durante la vigencia del préstamo, que se aumente la cantidad de la cuota mensual o que se incremente el número de los pagos. En el cuadro siguiente, se presentan cálculos
   aproximados de las cuotas mensuales de un préstamo sin subsidio del interés, hecho por un monto de $15,000 y con una tasa de 9 por ciento, después de un período de aplaza-
   miento de pago de 12 meses de duración. Se comparan los efectos de las diferentes maneras de tratar los intereses del préstamo: pagarlos a medida que se van produciendo,
   capitalizarlos al final del período de aplazamiento de pago y capitalizarlos trimestralmente y al final del período de aplazamiento de pago. El costo efectivo de los intereses de mi
   préstamo dependerá de la tasa de interés, de la duración del aplazamiento de pago y de la frecuencia de capitalización de los intereses. Como se puede apreciar en el cuadro, si
   los intereses se van pagando durante el período del aplazamiento de pago, la cuota mensual se rebaja en unos $18 y se ahorran casi $772 durante la vigencia del préstamo.
        Tratamiento de los intereses producidos          Cantidad del        Intereses capitalizados        Capital a        Cuota          Número                         Total pagado
                                                                                                                                                         Total pagado
              durante el aplazamiento de pago             préstamo                 (12 meses)                pagar          mensual        de cuotas                       en intereses
       Pagar los intereses durante
                                                          $15,000.00                   $0.00               $15,000.00        $190.01          120         $24,151.64*        $9,151.64
       el aplazamiento de pago
       Capitalizar los intereses al final
                                                          $15,000.00                 $1,350.00             $16,350.00        $207.11          120         $24,853.79         $9,853.79
       del aplazamiento de pago
       Capitalizar los intereses cada
        trimestre durante el aplazamiento                 $15,000.00                 $1,396.25             $16,396.25        $207.70          120         $24,924.09         $9,924.09
       de pago y al final del mismo
   * El total pagado incluye los $1,350 de intereses pagados durante los 12 meses del aplazamiento de pago.
   El Federal Family Education Loan Program (Programa FFEL) incluye los Préstamos Federales Stafford (con y sin subsidio del interés), los Préstamos Federales
   Suplementarios para Estudiantes (SLS), los Préstamos Federales PLUS y los Préstamos Federales de Consolidación.
   Funcionarios y empleados autorizados para certificar los datos consignados:
   •   Oficial comandante o de personal (aplazamiento de pago por servicio en las Fuerzas Armadas)
   •   Funcionario autorizado del Servicio de Salud Pública de EE.UU. (aplazamiento de pago por servicio en el mismo)
   •   Funcionario autorizado del Cuerpo de Paz (aplazamiento de pago por servicio en el mismo)
   •   Funcionario autorizado del Programa ACTION (aplazamiento de pago por servicio en el mismo)
   •   Funcionario o empleado autorizado del programa de voluntarios correspondiente (aplazamiento de pago por servicio en una entidad exenta de impuestos)
   •   Funcionario autorizado del Cuerpo de NOAA (aplazamiento de pago por servicio en el mismo)
   Indulgencia de morosidad se refiere a la suspensión temporal de las cuotas del préstamo, a la prolongación del plazo de vencimiento de las cuotas o a la reducción temporal de
   la cantidad programada de las cuotas. Tengo la responsabilidad de pagar los intereses producidos por mis préstamos durante el período de indulgencia de morosidad. Si no
   pago los intereses, éstos pueden capitalizarse.




                                                                                     Página 2 de 4
SECCIÓN 7: REQUISITOS PARA ACOGERSE AL APLAZAMIENTO DE PAGO POR SERVICIO PÚBLICO
 Para poder acogerme al aplazamiento de pago por los motivos expuestos en la Sección 2 del presente formulario, debo cumplir con lo siguiente:
  • Debo tener un saldo pendiente de pago en algún préstamo hecho mediante el Programa FFEL antes del 1 de julio de 1993, o debía tener, en el momento de obtener otro
    préstamo que se desembolsó el 1 de julio de 1993 o posterior, un saldo pendiente en algún Préstamo FFEL hecho antes del 1 de julio de 1993. En caso de haber obtenido
    Préstamos Federales PLUS, (1) no puedo acogerme al aplazamiento de pago de estos préstamos por razones del servicio en la NOAA, pero (2) la prestación de servicio en las
    Fuerzas Armadas, en el Servicio de Salud Pública, en el Cuerpo de Paz, en los Programas ACTION y en entidades exentas de impuestos, sí puede servir de motivo para la
    concesión del aplazamiento de pago de los préstamos hechos antes del 15 de agosto de 1983. Debo haber obtenido, para efectos del aplazamiento de pago por servicio en
    la NOAA, Préstamos Federales Stafford o Préstamos SLS y haber obtenido el primero de los mismos el 1 de julio de 1987 o posterior pero antes del 1 de julio de 1993, o
    debía haber tenido, en el momento de obtener otro préstamo el 1 de julio de 1993 o posterior, un saldo pendiente de pago en algún préstamo obtenido el 1 de julio de 1987
    o posterior pero antes del 1 de julio de 1993.
 Puedo acogerme al aplazamiento del pago de mis préstamos mientras:
  • Presto servicio activo en las FUERZAS ARMADAS de los Estados Unidos. (La duración máxima del aplazamiento otorgado por esta razón es de tres años, ya sean
    calculados a partir de este tipo de servicio solamente o de éste en combinación con el servicio en la NOAA o en el Servicio de Salud Pública.) Para poder acogerme al
    aplazamiento de pago por este motivo, debo: (1) encontrarme en situación de servicio activo en el Ejército, Fuerza Aérea, Marina, Infantería de la Marina o Guardacostas y (2)
    aportar a mi acreedor copia de mi tarjeta de identidad militar y ordenes, o gestionar que el oficial comandante o de personal certifique la Sección 4, en la primera página del
    presente formulario. Nota: Pueden acogerse al aplazamiento los prestatarios alistados en un componente de la reserva de las Fuerzas Armadas o en la Guardia Nacional
    (mientras se hallan en situación de servicio activo en la Reserva del Ejército o de la Fuerza Aérea), siempre que presten servicio (1) a tiempo completo, durante un período que
    se prevé que dure por lo menos un año, o (2) como consecuencia de una movilización nacional.
  • Presto servicio a tiempo completo en calidad de oficial en el Cuerpo de Comisionados del SERVICIO DE SALUD PÚBLICA. (La duración máxima del aplazamiento otorgado
    por esta razón es de tres años, ya sean calculados a partir de este tipo de servicio solamente o de éste en combinación con el servicio en las Fuerzas Armadas o en la NOAA.)
  • Presto servicio en el CUERPO DE PAZ. (La duración máxima del aplazamiento es de tres años.) Para poder acogerme al aplazamiento por este motivo, deberé haber
    aceptado prestar servicio durante un período mínimo de un año. Nota: En lugar de que firme la Sección 4 del presente formulario un funcionario autorizado del Cuerpo de Paz,
    se puede aportar al acreedor constancia de la fecha de inicio del servicio en el Cuerpo de Paz y la fecha prevista de su terminación. Esta documentación deberá ser firmada y
    fechada por un funcionario autorizado del Cuerpo de Paz.
  • Presto servicio a tiempo completo como voluntario en los PROGRAMAS ACTION. (La duración máxima del aplazamiento es de tres años.) Para poder acogerme al
    aplazamiento por este motivo, deberé haber aceptado prestar servicio durante un período mínimo de un año.
  • Presto servicio a tiempo completo como voluntario en una ENTIDAD EXENTA DE IMPUESTOS. (La duración máxima del aplazamiento es de tres años.) Para poder
    acogerme al aplazamiento de pago por este motivo, debo: (1) trabajar a tiempo completo en una entidad que goza de exención impositiva al amparo de la Sección 501(c)(3) del
    Código de Rentas Internas de 1986; (2) ayudar a personas de escasos recursos, y a las poblaciones en que éstas residen, a eliminar la pobreza y las condiciones personales,
    sociales y ambientales que guarden relación con la misma; (4) abstenerse de la instrucción religiosa, el proselitismo, la recaudación de fondos en apoyo de actividades
    religiosas y la celebración de cultos de adoración, durante el desempeño de mis deberes, y (5) haber aceptado prestar servicio durante un período mínimo de un año.
  • Presto servicio activo en la ADMINISTRACIÓN NACIONAL DE OCÉANOS Y ATMÓSFERA (NOAA). (La duración máxima del aplazamiento otorgado por esta razón es de
    tres años, ya sean calculados a partir de este tipo de servicio solamente o de éste en combinación con el servicio en las Fuerzas Armadas o en el Servicio de Salud Pública.)




                                                                                Página 3 de 4
SECCIÓN 8: DÓNDE ENVIAR EL FORMULARIO CON LOS DATOS COMPLETOS
Envíe el formulario con los datos completos, y cualquier otra documentación necesaria, a      Si necesita ayuda para llenar el formulario, llame al siguiente número:
la siguiente dirección:                                                                       (De no indicarse ningún número de teléfono, llame a su acreedor.)
(De no indicarse ninguna dirección, remita el formulario a su acreedor.)




SECCIÓN 9: AVISOS IMPORTANTES
Aviso sobre la Ley de Confidencialidad de Información
En virtud de la Ley de Confidencialidad de Información de 1974 (Sección 552a del Título 5 del Código de Estados Unidos), es obligatorio poner a disposición del solicitante el
siguiente aviso:
La autoridad para reunir la información solicitada por medio del presente formulario deriva de la Sección 421 y siguientes de la Ley de Educación Superior de 1965, según
enmendada (Sección 1071 y siguientes del Título 20 del Código de Estados Unidos). La autoridad para solicitar y utilizar el número de Seguro Social del solicitante deriva de la
Sección 484(a)(4) de la Ley de Educación Superior (Sección 1091[a][4] del Título 20 del Código de Estados Unidos) y de la Sección 7701(b) del Título 30 del Código de Estados
Unidos. Si bien tienen carácter voluntario tanto la participación en el Federal Family Education Loan Program (Programa FFEL) como el proporcionar el número de Seguro Social, el
solicitante deberá facilitar la información solicitada, incluido el número de Seguro Social, para poder participar en el Programa.
La reunión de la información solicitada en el presente formulario (incluido el número de Seguro Social) se realiza con los siguientes fines principales: verificar la identidad del
solicitante; determinar el otorgamiento, al amparo del Programa FFEL, de préstamos nuevos o de beneficios en materia del pago de préstamos existentes (como por ejemplo, el
aplazamiento de pago, la indulgencia de morosidad, y la anulación o condonación de deudas); administrar los préstamos del solicitante, y, en caso de mora o incumplimiento de
pago, localizarlo, exigirle el pago de la deuda e informar a las entidades competentes la condición de los préstamos. También hacemos uso del número de Seguro Social como
identificador de la cuenta de préstamos del solicitante y para permitir a éste acceder electrónicamente a los datos relativos a la misma.
Al amparo de una cláusula, debidamente publicada en el sistema de registro de datos correspondiente, relativa al uso normal de la información recogida, los datos que se encuentran
en el expediente del solicitante se pueden poner a disposición de terceras entidades, ya sea según las circunstancias particulares del caso o en cumplimiento de un programa de
cotejo electrónico de datos. Tratándose del presente formulario, el uso normal de esta información incluye, sin carácter limitativo, la cesión de los datos a ciertas partes, señaladas
abajo, a fin de hacer lo siguiente: verificar la identidad del solicitante; determinar el otorgamiento de préstamos nuevos o de beneficios en materia del pago de préstamos existentes;
permitir la administración o cobro de los préstamos; hacer cumplir los términos y condiciones de los préstamos; investigar la posible comisión de fraude y verificar el cumplimiento de
las normas que rigen los programas federales de ayuda económica para los estudios superiores o localizar al solicitante en caso de mora o incumplimiento de pago. Las siguientes
son las partes a las que podemos destinar la información reunida: organismos federales, estatales y locales; particulares que tienen alguna relación con el solicitante, tales como
familiares, empleadores actuales y pasados, socios comerciales y personales; agencias de informes crediticios; instituciones educativas y financieras, y garantes. Para informar
sobre los cálculos del índice de incumplimiento de pago, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos estatales. Para facilitar el
historial de ayuda económica del solicitante, podemos ceder los datos a instituciones educativas. Para ayudar a los administradores del programa a llevar un control sobre la
devolución de fondos de préstamo y la anulación de préstamos, podemos ceder los datos a garantes, a instituciones financieras y educativas, o a organismos federales o estatales.
Para establecer un método estandarizado según el cual instituciones educativas puedan informar de forma eficiente sobre la dedicación de estudio del solicitante, podemos ceder los
datos a garantes o a instituciones financieras y educativas. Para dar orientación al solicitante en materia del pago de préstamos, podemos ceder los datos a garantes, a instituciones
financieras y educativas, o a organismos federales, estatales o locales.
En caso de litigio, podemos enviar los datos del solicitante al Departamento de Justicia, o al tribunal, entidad jurídica, abogado, parte o testigo correspondientes, cuando dicha cesión
se considere procedente y necesaria para la solución del mismo. Si estos datos, ya sean por separado o en conjunto con otra información, indican una posible violación de la ley,
podemos enviarlos a las autoridades competentes, para que se tomen las medidas pertinentes. Podemos enviar la información a congresistas en caso que usted les pida ayuda con
algún problema relacionado con los programas federales de asistencia estudiantil. En caso de denuncias, quejas o medidas disciplinarias en materia de empleo, podemos ceder los
datos a las entidades competentes, a fin de facilitar la adjudicación o investigación de las mismas. Si así se dispone en una convención colectiva de trabajo, podemos ceder los
datos a los sindicatos debidamente reconocidos al amparo del Capítulo 71 del Título 5 del Código de Estados Unidos. Podemos poner los datos a disposición de nuestros
contratistas si los necesitan para realizar funciones relacionadas con los programas en referencia. Antes de hacerlo, requerimos que el contratista ponga en práctica las medidas de
protección necesarias para cumplir con la Ley de Confidencialidad de Información. Los datos también pueden cederse, de conformidad con las protecciones previstas en la Ley de
Confidencialidad de Información, a aquellos investigadores que reúnan los requisitos correspondientes.
Aviso sobre la Ley de Reducción de Trámites
Según lo dispuesto en la Ley de Reducción de Trámites de 1995, ninguna persona estará en la obligación de responder a un instrumento de recolección de datos que no exhiba un
número de control vigente emitido por la Oficina de Administración y Presupuesto (OMB, por sus siglas en inglés). Para efectos del presente formulario, dicho número es 1845-0005.
Se calcula que se necesitan, como promedio, 0.16 horas (10 minutos) por respuesta, incluido el tiempo para leer las instrucciones, buscar la información en los documentos
correspondientes, reunir los datos necesarios, consignarlos en el formulario y revisarlos. Si usted tiene algún comentario sobre la exactitud de estos cálculos, o alguna
sugerencia sobre cómo mejorar el presente formulario, escriba a la siguiente dirección:
U.S. Department of Education, Washington, DC 20202-4537
Si tiene preguntas sobre el estado de tramitación de su formulario, escriba a la dirección indicada en la Sección 8.




                                                                                   Página 4 de 4
                    TEMPORARY TOTAL DISABILITY DEFERMENT REQUEST                                                                                                  OMB No. 1845-0005
                    Federal Family Education Loan Program                                                                                                         Form Approved
                                                                                                                                                                  Exp. Date 05/31/2012
                    Use this form only if you have an outstanding balance on a Federal Family Education Loan Program loan that was made before July 1, 1993, or
                    had a balance on a loan that was made before July 1, 1993, at the time you obtained a loan disbursed on or after July 1, 1993.
                    WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents is
TDIS                subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.

SECTION 1: BORROWER IDENTIFICATION
                                                                                                    Please enter or correct the following information.
                                                                                                    SSN |__|__|__|-|__|__|-|__|__|__|__|
                                                                                                    Name
                                                                                                    Address
                                                                                                    City, State, Zip Code
                                                                                                    Telephone - Home (        )
                                                                                                    Telephone - Other (       )
                                                                                                    E-mail Address (Optional)
SECTION 2: DEFERMENT REQUEST
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 5, 6, and 7. A representative may complete
and sign this form on your behalf if you are unable to do so because of your disability.
 I meet the qualifications stated in Section 7 on the following page for a Temporary Total Disability Deferment and request that my loan holder defer repayment on my loans while I
  am TEMPORARILY TOTALLY DISABLED or while I am unable to secure employment because I am caring for a spouse or dependent who is TEMPORARILY TOTALLY
  DISABLED. Check the appropriate box:
       I am disabled.
       I am taking care of my spouse or dependent who is disabled. (For spouse or dependent disability, provide the information requested below.)
        Name of Spouse or Dependent:                                                                           Relationship to Borrower:

SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATIONS
 I understand that: (1) I am not required to make payments of loan principal during my deferment. Interest will not be charged on my subsidized loan(s) during my deferment.
   However, interest will be charged on my unsubsidized loan(s). (2) I have the option of paying the interest that accrues on my unsubsidized loan(s) during my deferment. (3) I
   may choose to make interest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period.
        I wish to make interest payments on my unsubsidized loan(s) during my deferment.
   (4) My deferment will begin on the date the condition that qualifies me for the deferment began. (5) My deferment will end on the earlier of the date that the condition that qualifies
   me for the deferment ends or the date it is expected to end, as certified by the physician who completes Section 4. However, my deferment will last no longer than 6 months after
   the date of my physician’s certification. (6) If my deferment does not cover all my past due payments, my loan holder may grant me a forbearance for all payments due before the
   begin date of my deferment or—if the period for which I am eligible for a deferment has ended—a forbearance for all payments due at the time my deferment request is processed.
   (7) My loan holder may grant me a forbearance on my loans for up to 60 days, if necessary, for the collection and processing of documentation related to my deferment request.
   Interest that accrues during the forbearance will not be capitalized. (8) If I am a veteran, the certification by a physician on this form is only for the purposes of establishing my
   eligibility to receive a deferment of a FFEL Program loan and is not for purposes of determining my eligibility for or the extent of my eligibility for Department of Veterans Affairs
   benefits.
 I certify that: (1) The information I provided in Sections 1 and 2 above is true and correct. (2) I will provide additional documentation to my loan holder, as required, to support my
   deferment status. (3) I will notify my loan holder immediately when the condition(s) that qualified me for the deferment ends. (4) I have read, understand, and meet the eligibility
   criteria of the deferment for which I have applied, as explained in Section 7.
 I authorize any physician, hospital, or other institution having records about the disability for which I am requesting a deferment of loan payments to make information from these
   records available to the holder of my loans.
 I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to contact me regarding my loan(s), including repayment of my
   loan(s), at the current or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded
   voice or text message.
Signature of Borrower or Borrower’s Representative                                                                            Date
Name of Borrower’s Representative (if applicable)                                                                                 Relationship to Borrower
Address of Borrower’s Representative                                                                                              Telephone (       )

SECTION 4: PHYSICIAN’S CERTIFICATION
Instructions for physician: You are being asked to complete and sign this form to certify that the borrower or the borrower’s spouse or dependent identified above in Section 2 is
temporarily totally disabled. You may complete this form only if you are a doctor of medicine or osteopathy legally authorized to practice. Sign the certification only if the disabled
person’s condition meets the definition of Temporary Total Disability in Section 7. Provide all requested information (you may attach additional pages). Report dates as month-day-
year (MM-DD-YYYY).
 The disabled person became unable to work and earn money or attend school, or required continuous nursing or similar care on |__|__|-|__|__|-|__|__|__|__|. The disabling
   condition or care is expected to continue until |__|__|-|__|__|-|__|__|__|__|.
 Diagnosis of the disabled person’s present medical condition (Do not use abbreviations or insurance codes):
 I certify that, in my best professional judgment, the borrower identified above in Section 2 is unable to work and earn money or attend school for at least 60 days because of a
  medically determinable impairment, or the borrower’s spouse or dependent identified above in Section 2 requires continuous nursing or similar care for a period of at least 90 days.
  I am a doctor of medicine or osteopathy legally authorized to practice.
Physician’s Name (printed)                                                                                                    Telephone (       )
Address                                                                                                                       City, State, Zip Code
Physician’s signature                                                                                                         Date


                                                                                          Page 1 of 3
SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Report dates as month-day-year (MM-DD-YYYY). For example, ’January 31, 2009’ = ‘01-31-2009’. A doctor of medicine or osteopathy legally authorized
to practice must complete Section 4. If you need help completing this form, contact your loan holder.
Return the completed form and any required documentation to the address shown in Section 8.
SECTION 6: DEFINITIONS
 Capitalization is the addition of unpaid interest to the principal balance of my loan. The principal balance of a loan increases when payments are postponed during periods of
  deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more
  payments may be required. The chart below provides estimates, for a $15,000 unsubsidized loan balance at a 9% interest rate, of the monthly payments due following a 12-month
  deferment. It compares the effects of paying the interest as it accrues, capitalizing the interest at the end of the deferment, and capitalizing interest quarterly and at the end of the
  deferment. My actual loan interest cost will depend on my interest rate, length of the deferment, and frequency of capitalization. Paying interest during the period of deferment
  lowers the monthly payment by about $18 and saves about $772 over the lifetime of the loan, as depicted in the chart below.
             Treatment of Interest Accrued                 Loan         Capitalized Interest    Principal to          Monthly        Number of       Total Amount       Total Interest
                     During Deferment                     Amount          for 12 Months           Be Repaid           Payment        Payments           Repaid              Paid
      Interest is paid                                   $15,000.00            $0.00             $15,000.00           $190.01           120           $24,151.64*        $9,151.64
      Interest is capitalized at the end of deferment    $15,000.00          $1,350.00           $16,350.00           $207.11           120           $24,853.79         $9,853.79
      Interest is capitalized quarterly during
                                                         $15,000.00          $1,396.25           $16,396.25           $207.70            120          $24,924.09          $9,924.09
      deferment and at the end of deferment
   *Total amount repaid includes $1,350 of interest paid during the 12-month period of deferment.
 A deferment is a period during which I am entitled to postpone repayment of the principal balance of my loan(s). The federal government pays the interest that accrues during an
  eligible deferment for all subsidized Federal Stafford Loans and for Federal Consolidation Loans for which the Consolidation Loan application was received by my loan holder (1)
  on or after January 1, 1993, but before August 10, 1993, (2) on or after August 10, 1993, if it includes only Federal Stafford Loans that were eligible for federal interest subsidy, or
  (3) on or after November 13, 1997, for that portion of the Consolidation Loan that paid a subsidized FFEL Program loan or a subsidized Federal Direct Loan. I am responsible for
  the interest that accrues during this period on all other FFEL Program loans.
 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal Supplemental Loans for Students (SLS),
  Federal PLUS Loans, and Federal Consolidation Loans.
 Forbearance means permitting the temporary cessation of payments, allowing an extension of time for making payments, or temporarily accepting smaller payments than
  previously scheduled. I am responsible for paying the interest that accrues on my loan(s) during a forbearance. If I do not pay the interest that accrues, the interest may be
  capitalized.
 The holder of my FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the U.S. Department of Education.
 The physician who completes Section 4 of this form must be a doctor of medicine or osteopathy legally authorized to practice.
 Temporary Total Disability: The disabled borrower must, because of injury or illness, be unable to work and earn money or go to school for at least 60 days in order to recover. If
  the disabled person is the borrower’s spouse or dependent, the disabled person must require at least 90 days of continuous nursing or similar care from the borrower. An
  uncomplicated pregnancy is not a qualifying condition for a pregnant borrower, or for a borrower caring for a spouse or dependent with an uncomplicated pregnancy.
SECTION 7: ELIGIBILITY CRITERIA FOR TEMPORARY TOTAL DISABILITY DEFERMENT REQUEST
 To qualify for a Temporary Total Disability Deferment, I must have an outstanding balance on a FFEL Program loan which was made before July 1, 1993, or I must have had an
  outstanding balance on a FFEL Program loan made before July 1, 1993, when I obtained a loan disbursed on or after July 1, 1993.
 I may defer repayment of my loan(s) while I am, or my spouse or dependent is, TEMPORARILY TOTALLY DISABLED. (Maximum eligibility is 3 years. Eligibility must be
   recertified every 6 months.)
   To qualify:
   (1) I must be unable to work and earn money or go to school for at least 60 days in order to recover from an injury or illness.
   (2) I must not be requesting this deferment based on a condition that existed before I applied for my loan(s) (underlying loan(s) in the case of a Consolidation Loan), unless my
       condition has since substantially deteriorated, and I am now temporarily totally disabled.
   (3) I must not be requesting this deferment based on an uncomplicated pregnancy (either my pregnancy, or my spouse’s or dependent’s uncomplicated pregnancy).
   (4) If I am requesting this deferment based on the disability of my spouse or dependent, my spouse or dependent must have an injury or illness that requires at least 90 days of
       continuous nursing or similar care from me, which prevents me from securing full-time employment of at least 30 hours per week in a position expected to last at least 3 months.
   (5) I understand that my physician (or my spouse’s or dependent’s physician) must recertify this condition every 6 months to continue this deferment.
SECTION 8: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST
Return the completed deferment request and any required documentation to:                      If you need help completing this form, call:
(If no address is shown, return to your loan holder.)                                          (If no telephone number is shown, call your loan holder.)




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SECTION 9: IMPORTANT NOTICES
Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §421 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1071 et seq.) and the
authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family
Education Loan Program (FFELP) and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan
(such as a deferment, forbearance, discharge, or forgiveness) under the FFELP, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and
report on your loan(s) if your loan(s) becomes delinquent or in default. We also use your SSN as an account identifier and to permit you to access your account i